Premium
EP26.03: Amnioinfusion for variable decelerations by umbilical cord compression without oligohydramnios “sandwich sign” as an early deteriorating marker
Author(s) -
Katsura D.,
Takahashi Y.,
Iwagaki S.,
Chiaki R.,
Asai K.,
Matsui M.,
Nagai R.,
Yasumi S.,
Furuhashi M.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.21647
Subject(s) - oligohydramnios , medicine , umbilical artery , umbilical cord , amnioinfusion , umbilical vein , fetus , gestational age , cord , obstetrics , cardiology , pregnancy , surgery , anatomy , biochemistry , genetics , chemistry , biology , in vitro
without oligohydramnios “sandwich sign” as an early deteriorating marker Daisuke Katsura Shiga University of Medical Science Hospital, Japan Objectives Amnioinfusion (AI) relieves umbilical cord compression caused by oligohydramnios during pregnancy and labor. We report prophylactic AI for variable decelerations (VD) in umbilical cord compression without oligohydramnios as an early sign of deterioration. Methods We performed transabdominal AI for cases without oligohydramnios but with ultrasonography findings of umbilical cord compression (sandwich sign [SWS]) and variable decelerations (VD) in fetal heart rate. SWS shows localied oligohydramnios and a stuck umbilical cord (Figure 1). VD frequency and fetal Doppler flow velocity were evaluated. Results Thirteen cases and 21 AIs were analyzed. Nine cases (69%) were fetal growth restriction, 9 cases (69%) had umbilical hyper-coiled cords, mean gestational age (GA) at the first AI was 31.8 weeks, mean number of AIs was 3.6, mean GA at delivery was 34.6 weeks, and mean time until delivery Conclusion Even if there is no oligohydramnios, AI might relieve umbilical cord compression, decrease vascular resistance of the umbilical artery, increase umbilical venous blood flow, and improve oxygenation. AI may be a new and promising treatment option to prevent adverse events including oligohydramnios and anhydroamnios. Figure 1. Ultrasound finding: sandwich sign.