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ISSN: 0300-9041
ISSNe: 2594-2034

Indizada en: SciELO, Índice Médico Latinoamericano, LILACS, Medline
Editada por la Federación Mexicana de Colegios de Obstetricia, y Ginecologia AC
Fundada por la Asociación Mexicana de Ginecología y Obstetricia en 1945
 

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INFORMACIÓN EXCLUSIVA PARA LOS PROFESIONALES DE LA SALUD

Periodicidad: continua
Abreviatura: Ginecol Obstet Mex
ISSN: 0300-9041
ISSNe: 2594-2034
Indizada en: Scimago, Índice Médico Latinoamericano, Lilacs, Medline, Science Citation Index, Ulrich, Ebsco.

Caso clínico

Trombosis silenciosa de la arteria umbilical en el tercer trimestre del embarazo: reporte de dos casos y revisión bibliográfica

Silent umbilical artery thrombosis in the third trimester of pregnancy: Report of two cases and literature review.

Ginecol Obstet Mex. 2021; 89 (5): 399-404.

https://doi.org/10.24245/gom.v89i5.4681

Francisco Ibargüengoitia-Ochoa,1 Josefina Lira-Plascencia,2 Fabiola Gallardo-Gómez,1 Salvador Jiménez-Chaidez,1 Francisco Ruiloba-Portilla,1 Cintia María Sepúlveda-Rivera1

1 Departamento de Obstetricia.
2 Departamento de Adolescencia.
Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México.


Corrrespondencia:

Cintia María Sepúlveda Rivera
cintiia_sepulveda@hotmail.com

Debe citarse como:

Ibargüengoitia-Ochoa F, Lira-Plascencia J, Gallardo-Gómez F, Jiménez-Chaidez S, Ruiloba-Portilla F, Sepúlveda-Rivera CM. Trombosis silenciosa de la arteria umbilical en el tercer trimestre del embarazo: reporte de dos casos y revisión bibliográfica. Ginecol Obstet Mex. 2021; 89 (5): 399-404. https://doi.org/10.24245/gom.v89i5.4681

Resumen

ANTECEDENTES: La trombosis de la arteria umbilical es una complicación rara durante el embarazo, con incidencia que varía de 0.0025 a 0.045%. El diagnóstico se establece en la autopsia o estudio histopatológico de la placenta y el cordón umbilical.

OBJETIVO: Analizar los desenlaces perinatales en dos pacientes con trombosis de la arteria umbilical.

CASO CLÍNICO: Caso 1. Paciente de 22 años, con 38 semanas de embarazo, sin comorbilidades. A la finalización del embarazo se advirtió la trombosis de la arteria umbilical confirmada por histopatología. No se documentaron desenlaces adversos maternos ni fetales en el periodo perinatal. Caso 2. Paciente de 23 años, con 37.0 semanas de embarazo, diagnóstico de colestasis intrahepática y ruptura prematura de membranas de larga evolución (26 horas). Luego de la finalización del embarazo por vía vaginal se observó una trombosis de la arteria umbilical que se corroboró en el estudio histopatológico. El neonato tuvo sepsis temprana y encefalopatía hipóxico-isquémica que ameritó su traslado a la unidad de cuidados intensivos hasta su alta por mejoría a los 18 días de vida extrauterina.

CONCLUSIONES: El diagnóstico y tratamiento de pacientes con trombosis de la arteria umbilical es un reto para el obstetra por la complejidad de su diagnóstico antes del nacimiento y las condiciones maternas o fetales asociadas.

PALABRAS CLAVE: Trombosis de la arteria umbilical; embarazo; placenta; arteria umbilical; condiciones fetales.

Abstract

BACKGROUND: Umbilical artery thrombosis is a rare complication during pregnancy, with incidence ranging from 0.0025 to 0.045%. The diagnosis is established after an autopsy finding or histopathologic study of the placenta and umbilical cord.

OBJECTIVE: To analyze perinatal outcomes in two patients with umbilical artery thrombosis.

CASE REPORT: Case 1. 22-year-old patient, 38 weeks pregnant, with no comorbidities. At the end of pregnancy, umbilical artery thrombosis was noticed and confirmed by histopathology. No adverse maternal or fetal outcomes were documented in the perinatal period. Case 2. 23-year-old patient, 37.0 weeks pregnant, diagnosed with intrahepatic cholestasis and long-standing premature rupture of membranes (26 hours). After vaginal termination of pregnancy, umbilical artery thrombosis was observed and corroborated in the histopathological study. The neonate had early sepsis and hypoxic-ischemic encephalopathy that warranted his transfer to the intensive care unit until his discharge due to improvement at 18 days of extrauterine life.

CONCLUSIONS: The diagnosis and treatment of patients with umbilical artery thrombosis is a challenge for the obstetrician because of the complexity of its diagnosis before birth and associated maternal or fetal conditions.

KEYWORDS: Umbilical artery thrombosis; Pregnancy; Placenta; Umbilical artery; Fetal conditions.

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