Umbilical cord stricture is a recognized cause of fetal demise, but the exact etiology remains unknown. The risk of recurrence has generally been thought to be low.
Three of 4 fetuses of a single patient died between 28 and 30 weeks of gestation; all were found to have stricture of the umbilical cord at the fetal insertion. Her one surviving infant was delivered emergently at 25 weeks. All infants were growth restricted but had no anatomic abnormalities.
Umbilical cord stricture was diagnosed as the cause of all 3 fetal deaths. Patients with a demise attributed to umbilical cord stricture should be counseled that the risk of recurrent cord stricture is undetermined.