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.