Clinical analysis of prenatal stillbirth caused by umbilical cord torsion

Objective This study aims to investigate the high-risk factors and ultrasonic examination of prenatal stillbirth caused by umbilical cord torsion (UCT). Method We retrospectively analyzed the electronic data of 424 pregnant women with UCT who delivered from January 2013 to February 2024 in Tongji Hospital, Tongji Medical College, University of Science and Technology. The subjects were divided into a stillbirth group (36 cases) and a live fetus group (388 cases) based on fetal conditions. In addition, demographic data, clinical manifestations, pregnancy complications and comorbidities, abnormalities of the fetus and its appendages, ultrasound diagnosis, as well as other data of the two groups were collected. The risk factors of stillbirth caused by UCT were analyzed through univariate and multivariate logistic regression analyses. Results Multiple Logistic regression analysis revealed that fetal growth restriction (FGR), history of decreased or vanished fetal movement, history of slow fetal heart rate, oligohydramnios, hydramnios, and umbilical cord root torsion at the umbilical chakra were independent risk factors for prenatal stillbirth caused by UCT (P < 0.05, OR > 1). Based on ultrasonic examination, the missed diagnosis rate of UCT in the stillbirth group was 91.7%. Conclusion High-risk factors for prenatal stillbirth caused by UCT include FGR, a history of decreased or vanished fetal movement, a history of slow fetal heart rate, oligohydramnios, hydramnios, and umbilical cord root torsion at the umbilical wheel. Prenatal stillbirth is related to the position of the UCT rather than the number of weeks. Prenatal ultrasound detects UCT at a low rate.