Two cases of umbilical vein thrombosis, one with associated portal vein thrombosis.

BACKGROUND

Thrombosis of the umbilical vessels is extremely rare. It is unpredictable and is associated with high perinatal mortality. Few cases with neonatal survival have been reported.

CASES: We identified two instances of umbilical vein thrombosis occurring two weeks apart in the same unit. Each case was identified at the time of delivery and each had a good outcome. In the first case, a 22-year-old primigravid woman had severe fetal bradycardia develop in the second stage of labour. Delivery was expedited with vacuum extraction, and a large thrombus in the umbilical vein was noted. In the second case, a 23-year-old multigravid woman underwent emergency Caesarean section because of a non-reassuring fetal heart tracing before the onset of labour. An umbilical cord thrombus was noted at delivery. The infant was later found to have a portal vein thrombus but subsequently did well.

CONCLUSION

When a neonate is found to have a thrombosis in the umbilical cord, it is prudent to rule out portal vein thrombosis. End-organ damage in the infant should be considered, and a thrombophilia screen is warranted.