Circular cervical

Circular cervical
Circular cervical
Feto no útero com o cordão umbilical enrolado à volta do pescoço e braço
Sinónimos Cordão nucal, cordão umbilical cervical, circular cervical do cordão umbilical
Especialidade Obstetrícia, pediatria
Sintomas Escurecimento da face, petéquia facial, hemorragia na parte branca dos olhos[1]
Complicações Mecónio, stress respiratório, anemia, morte fetal[1]
Método de diagnóstico Suspeita baseada no ritmo cardíaco do bebé durante o parto, confirmado por ecografia[1]
Condições semelhantes Asfixia perinatal[1]
Tratamento Desemaranhar o cordão durante o parto ou, se não for possível, cortar o cordão[2]
Prognóstico Geralmente favorável[1]
Frequência 25% dos partos[2]
Classificação e recursos externos
CID-11 1060008055
MeSH D053589
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Circular cervical ou cordão nucal é o enrolamento do cordão umbilical em redor do pescoço do feto.[1] Entre os sintomas presentes no bebé imediatamente após um parto com circular cervical estão o escurecimento da face, petéquia facial e hemorragia na parte branca dos olhos.[1] Entre as possíveis complicações estão a presença de mecónio, stress respiratório, anemia e morte fetal.[1] O risco é maior quanto maior o número de emaranhamentos do cordão.[3]

O diagnóstico pode ser suspeitado quando se verifica uma diminuição do ritmo cardíaco do bebé durante o parto.[1] Assim que a cabeça passa pelo canal de parto, geralmente o obstetra passa um dedo à volta do pescoço para verificar se o cordão se encontra enrolado.[4] Antes do parto, a condição pode ser confirmada com ecografia.[1]

Quando o enrolamento do cordão é detectado durante o parto, o tratamento consiste em tentar desenrolar o cordão ou, quando isto não é possível, em cortar o cordão umbilical.[2] Geralmente, o parto decorre de forma normal e o prognóstico é favorável.[1][5] Em casos raros podem ocorrer lesões paralisia cerebral.[1][6] As circulares cervicais ocorrem em cerca de um quarto dos partos.[2] A condição tem sido descrita desde pelo menos cerca de 300 a.C. por Hipócrates.[1]

Referências

  1. ↑ a b c d e f g h i j k l m Peesay, Morarji (6 de dezembro de 2017). «Nuchal cord and its implications». Maternal Health, Neonatology and Perinatology. 3 (1). 28 páginas. PMC 5719938Acessível livremente. PMID 29234502. doi:10.1186/s40748-017-0068-7 
  2. ↑ a b c d «Nuchal Cord». Merck Manuals Consumer Version. Junho de 2018. Consultado em 2 de outubro de 2018 
  3. ↑ Hasegawa, J; Matsuoka, R; Ichizuka, K; Sekizawa, A; Okai, T (março de 2009). «Ultrasound diagnosis and management of umbilical cord abnormalities.». Taiwanese Journal of Obstetrics & Gynecology. 48 (1): 23–7. PMID 19346188. doi:10.1016/S1028-4559(09)60031-0 
  4. ↑ Ferri, Fred F. (2014). Ferri's Clinical Advisor 2015 E-Book: 5 Books in 1 (em inglês). [S.l.]: Elsevier Health Sciences. p. e23. ISBN 9780323084307 
  5. ↑ Adams, James G. (2012). Emergency Medicine E-Book: Clinical Essentials (Expert Consult -- Online) (em inglês). [S.l.]: Elsevier Health Sciences. p. 1064. ISBN 978-1455733941 
  6. ↑ MacLennan, AH; Thompson, SC; Gecz, J (dezembro de 2015). «Cerebral palsy: causes, pathways, and the role of genetic variants.». American Journal of Obstetrics and Gynecology. 213 (6): 779–88. PMID 26003063. doi:10.1016/j.ajog.2015.05.034 

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