@article{oai:redcross.repo.nii.ac.jp:00012136,
 author = {Kenji, Yorita and Yohei, Takahashi and Yu, Tanaka and Yuka, Kai and Koki, Hirano and Tetsuro, Furumoto and Takanori, Abe and Naoto, Kuroda and Keiko, Mizuno and Masahiko, Ohara and Kaori, Yasuoka and Yukari, Wada and Yoshiko, Agatsuma and Yuichiro, Sato and Akihiko, Mochizuki},
 issue = {1},
 journal = {高知赤十字病院医学雑誌, Medical　Journal of Kochi Red Cross Hospital},
 month = {Mar},
 note = {The umbilical vessels have two arteries and one vein, and thrombosis rarely occurs
in the umbilical vein and arteries. Umbilical artery thrombosis (UAT) has a low incidence rate
compared with umbilical venous thrombosis. Discordant umbilical arteries (DUAs), wherein the
size of the arteries is different, has rarely been reported, and the smaller umbilical artery has also
been described as the hypoplastic umbilical artery (HUA). UAT and HUA/DUAs can be related
to poor perinatal outcomes or fetus malformation. We herein present a case of a nulliparous and
primigravid 37-year-old Japanese pregnant woman, with sonographic diagnosis of single umbilical
artery at 24 weeks of gestation by the loss of left-sided umbilical artery. Subsequently, serological
test showed elevated serum immunoglobulin M (IgM) and IgG antibodies for cytomegalovirus
(CMV). Neither morphological nor growth abnormality of the fetus was sonographically found,
and no CMV DNA was detected in the vaginal discharge. Clinical follow-up was performed, and
the fetus was small for gestational age during the course of the observation. At 40 and 5/7 weeks
of gestation, vaginal delivery was attempted, but cesarean delivery was performed because fetal
distress was suspected by cardiotocography. An appropriate-for-age female neonate without
anomaly was born, and the Apgar score was 8 and 9 after 1 and 5 min, respectively. Neither
elevated serum anti-CMV IgM antibodies nor presence of CMV DNA in the urine was found in
the neonate. Six days after cesarean section, the mother and neonate were discharged without
any problems. A thin and hypercoiled umbilical cord was found macroscopically, and pathology
confirmed that the umbilical cord had one vein and two arteries, which included an HUA showing
occlusive thrombosis. The placenta showed no apparent abnormalities except for a small infarction
at the marginal zone. CMV infection was not found in the umbilical cord and placenta. The
pathogenesis of UAT was speculated to be related to the hypercoiled umbilical cord. This is the
first case of a healthy, appropriate-for-age, full-term neonate born with UAT.},
 pages = {31--37},
 title = {A case of a pregnant woman giving birth to a healthy neonate, complicated with a hypercoiled umbilical cord and umbilical artery thrombosis(和訳中)},
 volume = {21},
 year = {2017}
}