Fetal death due to umbilical cord thrombosis in association with a swallowed amniotic string

We report the exceptional case of an intrauterine fetal death due to the umbilical vein thrombosis in association with a swallowed amniotic string and other pathological features of the umbilical cord. The case concerns a full-term pregnancy, the woman was just performing routinely antepartal CTG monitoring and, unexpectedly, no fetal heart beat could be recorded. An ultrasound check was immediately performed and confirmed the diagnosis of intrauterine fetal death. After labor induction a female fetus was delivered, no macroscopic external sign of malformation, except a thin fibrotic string hanging from the mouth was noticed. The following pathologic examination of fetus, placenta and umbilical cord showed an unlucky combination of adverse variables contributing all together to the fetal demise. In fact the umbilical cord presented a thrombus in the venous vessel, an absolute shortness, an eccentric insertion, and an amniotic band coiled around its origin. Finally it was confirmed the amniotic origin of the string, total length of 53,5 cm, hanging from the mouth, with its deepest part in the stomach.