Nonneoplastic placental conditions and abnormalities

Umbilical cord


Topic Completed: 1 August 2015

Minor changes: 29 October 2020

Copyright: 2002-2021,, Inc.

PubMed Search: Hematoma [title] umbilical cord

Paul J. Kowalski, M.D.
Page views in 2020: 1,618
Page views in 2021 to date: 1,519
Cite this page: Kowalski PJ. Hematoma. website. Accessed December 3rd, 2021.
Definition / general
  • Extravasation of blood from an umbilical vessel that subsequently accumulates in Wharton jelly
  • Hematoma or hemorrhage should be distinguished from umbilical cord thrombosis, which can be seen in association with a cord hematoma
  • Uncommon and estimated to occur in 1 per 5,000 - 13,000 deliveries
  • Hematomas typically occur at the fetal end of the umbilical cord
  • Typically unknown but may be due to a ruptured umbilical vein varix (cystic vascular dilatation), trauma including therapeutic procedures (amniocentesis, cordocentesis, etc.) and cord abnormalities, such as traction occurring with short umbilical cords
Clinical features
  • Blood loss or compression of fetal vessels can lead to circulatory compromise, fetal distress and fetal death
  • Fetal mortality is estimated at 40 - 50% when umbilical cord hematoma is present
Radiology description
  • Ultrasound can reveal cord expansion with a heteroechoic to hyperechoic mass or discordant umbilical artery Doppler waveforms
Case reports
  • Induction of delivery can be undertaken if fetal compromise is present
Clinical images

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Rupture of umbilical vessels

Gross images

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Hematoma of umbilical cord, placenta was delivered by cesarean section, no traction or clamping of this segment of cord

Microscopic (histologic) description
  • Nonspecific and variable hemorrhage involving Wharton jelly
  • Less commonly, evidence of vascular disruption, cystic changes or aneurysmal dilatation
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