European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 96, Issue 2 , Pages 150-157 , June 2001

Umbilical cord morphology and pregnancy outcome

  • Edoardo Di Naro

      Affiliations

    • Department of Obstetrics and Gynecology, University of Bari, Bari, Italy
    • Corresponding Author InformationCorresponding author. Tel.: +39-80-501-4648; fax: +39-80-547-8928
    • ,
  • Fabio Ghezzi

      Affiliations

    • Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
    • ,
  • Luigi Raio

      Affiliations

    • Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland
    • ,
  • Massimo Franchi

      Affiliations

    • Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
    • ,
  • Vincenzo D’Addario

      Affiliations

    • Department of Obstetrics and Gynecology, University of Bari, Bari, Italy

Received 21 April 2000 ,Revised 13 July 2000 ,Accepted 1 August 2000.

References 

  1. Benirschke K, Kaufmann P. Pathology of the human placenta. 3rd ed. New York: Springer, 1995.
  2. Bacsich P, Smout CFV. Some observations on the foetal vessels of the human placenta with an account of the corrosion technique. J. Anat. 1938;72:358–364
  3. Malpas P, Symonds EM. Observations on the structure of the human umbilical cord. Surg. Gynecol. Obstet. 1966;123:746–750
  4. Heifetz SA. Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature. Perspect. Pediatr. Pathol. 1984;8:345–378
  5. Otsubo Y, Yoneyama Y, Suzuki S, Sawa R, Araki T. Sonographic evaluation of umbilical cord insertion with umbilical coiling index. J. Clin. Ultrasound. 1999;27:341–344
  6. Ercal T, Lacin S, Altunyurt S, Saygili U, Cinar O, Mumcu A. Umbilical coiling index: is it a marker for the foetus at risk? Br Clin Pract 1996;50:254–6.
  7. Wu MH, Chang FM, Shen MR, Yao BL, Chang CH, Yu CH, et al. Prenatal sonographic diagnosis of single umbilical artery. J. Clin. Ultrasound. 1997;26:425–430
  8. Persutte WH, Lenke RR. Transverse umbilical arterial diameter: technique for the prenatal diagnosis of single umbilical artery. J. Ultrasound Med. 1994;13:763–766
  9. Goffinet F, Paris J, Heim H, Nisard J, Breat G. Predictive value of Doppler umbilical artery velocimetry in a low risk population with normal fetal biometry. A prospective study of 2016 women. Eur. J. Obstet. Gynecol. Reprod. Biol. 1997;71:14–19
  10. Bartha JL, Comino-Delgado R, Gonzales-Mena C, Lopez I, Arrabal J. Umbilical blood flow and neonatal morphometry: a multivariate analysis. Eur. J. Obstet. Gynecol. Reprod. Biol. 1998;79:27–33
  11. Scorza WE, Nardi D, Vintziles AM, Fleming AD, Rodis JF, Campbell WA. The relationship between umbilical artery Doppler velocimetry and fetal biometry. Am. J. Obstet. Gynecol. 1991;165:1013–1019
  12. Bruch JF, Sibony O, Benali K, Challier C, Blot P, Nessmann C. Computerized microscope morphometry of umbilical vessels from pregnancies with intrauterine growth retardation and abnormal umbilical artery Doppler. Hum. Pathol. 1997;28:1139–1145
  13. Raio L, Ghezzi F, Di Naro E, Franchi M, Maymon E, Mueller MD, et al. Prenatal diagnosis of a “lean” umbilical cord: a simple marker for fetuses at risk of being small for gestational age at birth. Ultrasound Obstet. Gynecol. 1999;13:176–180
  14. Rana J, Ebert GA, Kenneth AK. Adverse perinatal outcome in patients with an abnormal umbilical coiling index. Obstet. Gynecol. 1995;85:573–577
  15. Strong TH, Elliott JP, Radin TG. Non-coiled umbilical blood vessels: a new marker for the fetus at risk. Obstet. Gynecol. 1993;81:409–411
  16. Barbera A, Galan HL, Ferrazzi E, Rigano S, Jozwik M, Battaglia FC, et al. Relationship of umbilical vein blood flow to growth parameters in the human fetus. Am. J. Obstet. Gynecol. 1999;181:174–179
  17. Pawlicka E, Bankowski E, Jaworski S. Elastin of the umbilical cord arteries and its alterations in EPH gestosis (preeclampsia). Biol. Neonate. 1999;75:91–96
  18. Bankowski E, Sobolewski K, Romanowicz L, Chyczewski L, Jawosrski S. Collagen and glycosaminoglycans of Wharton’s jelly and their alterations in EPH-gestosis. Eur. J. Obstet. Gynecol. Reprod. Biol. 1996;66:109–117
  19. Weissman A, Jakobi P. Sonographic measurements of the umbilical cord in pregnancies complicated by gestational diabetes. J. Ultrasound Med. 1997;16:691–694
  20. Hill LM, DiNofrio DM, Guzick D. Sonographic determination of first trimester umbilical cord length. J. Clin. Ultrasound. 1994;22:435–438
  21. Strong TH, Finberg HJ, Mattox JH. Antepartum diagnosis of noncoiled umbilical cords. Am. J. Obstet. Gynecol. 1994;170:1729–1733
  22. Sherer DM, Manning FA. Prenatal ultrasonographic morphologic assessment of the umbilical cord: a review. Part I. Obstet. Gynecol. Surv. 1997;52:506–514
  23. Sherer DM, Manning FA. Prenatal ultrasonographic morphologic assessment of the umbilical cord: a review. Part II. Obstet. Gynecol. Surv. 1997;52:515–523
  24. Weissman A, Jakobi P, Bronshtein M, Goldstein I. Sonographic measurements of the umbilical cord and vessels during normal pregnancies. J. Ultrasound Med. 1994;13:11–14
  25. Raio L, Ghezzi F, Di Naro E, Gomez R, Mueller MD, Maymon E, et al. Sonographic measurements of the umbilical cord and fetal anthropometric parameters. Eur. J. Obstet. Gynecol. Reprod. Biol. 1999;83:135–145
  26. Sloper KS, Brown RS, Baum JD. The water content of the human umbilical cord. Early Hum. Dev. 1979;3:205–210
  27. Gill P, Jarjoura D. Wharton’s jelly in the umbilical cord. A study of its quantitative variations and clinical correlates. J. Reprod. Med. 1993;38:612–614
  28. Goodlin RC. Fetal dysmaturity, “lean cord”, and fetal distress. Am. J. Obstet. Gynecol. 1987;156:716
  29. Hall PK. The thin cord syndrome. A review with a report of two cases. Obstet. Gynecol. 1961;18:507–509
  30. Sun Y, Arbuckle S, Hocking G, Billson V. Umbilical cord stricture and intrauterine fetal death. Pediatr. Pathol. Lab. Med. 1985;15:723–732
  31. Qureshi F, Jacques SM. Marked segmental thinning of the umbilical cord vessels. Arch. Pathol. Lab. Med. 1994;118:826–830
  32. Clausen I. Umbilical cord anomalies and antenatal fetal deaths. Obstet. Gynecol. Surv. 1989;44:841–845
  33. Silver RK, Dooley SL, Tamura RK, Depp R. Umbilical cord size and amniotic fluid volume in prolonged pregnancy. Am. J. Obstet. Gynecol. 1987;157:716–720
  34. Gebrane-Younes J, Minh HN, Orcel L. Ultrastructure of human umbilical vessels: a possible role in amniotic fluid formation?. Placenta. 1986;7:173–185
  35. Chantler C, Baum JD, Wigglesworth JS, Scopes JW. Giant umbilical cord associated with a patent urachus and fused umbilical arteries. J. Obstet. Gynecol. Br. Cwlth. 1969;76:273–274
  36. Iaccarino M, Baldi F, Persico O, Palagiano A. Ultrasonographic and pathologic study of mucoid degeneration of umbilical cord. J. Clin. Ultrasound. 1986;14:127–129
  37. Weissman A, Jakobi P. Sonographic measurements of the umbilical cord in pregnancies complicated by gestational diabetes. J. Clin. Ultrasound. 1997;16:691–694
  38. Dolkart LA, Reimers FT, Kuonen CA. Discordant umbilical arteries: ultrasonographic and Doppler analysis. Obstet. Gynecol. 1992;79:59–63
  39. Raio L, Ghezzi F, Di Naro E, Gomez R, Saile G, Brühwiler H. The clinical significance of antenatal detection of discordant umbilical arteries. Obstet. Gynecol. 1998;91:86–91
  40. Persutte WH, Hobbins J. Single umbilical artery: a clinical enigma in modern prenatal diagnosis. Ultrasound Obstet. Gynecol. 1995;6:216–219
  41. Raio L, Ghezzi F, Di Naro E, Franchi M, Brühwiler H. Prenatal identification of the Hyrtl anastomosis and its functional evaluation. Hum. Reprod. 1999;14:1890–1893
  42. Hitschold T, Braun S, Weiss E, Berle P, Beck T, Muntefering H. A case of discordant flow velocity waveforms in nonanastomoting umbilical arteries: a morphometric analysis. J. Matern. Fetal Invest. 1992;2:215–219
  43. Predanic M, Kolli J, Yousefzadeh P, Pennisi J. Disparate blood flow patterns in parallel umbilical arteries. Obstet. Gynecol. 1998;91:757–780
  44. Jones TB, Sorokin Y, Bhatia R, Zador I, Bottom SF. Single umbilical artery: accurate diagnosis?. Am. J. Obstet. Gynecol. 1993;169:358–360
  45. Catanzarite VA, Hendricks SK, Maida C, Westbrook C, Cousins L, Schrimmer D. Prenatal diagnosis of two vessels cord: implications for patients counseling and obstetrics management. Ultrasound Obstet. Gynecol. 1995;5:98–105
  46. Jauniaux E, Campbell S, Vyas S. The use of color Doppler imaging for prenatal diagnosis of umbilical cord abnormalities: report of three cases. Am. J. Obstet. Gynecol. 1989;161:1195–1196
  47. Persutte WH, Lenke RR. Transverse umbilical arterial diameter: a new technique for the prenatal diagnosis of single umbilical artery. J. Ultrasound Med. 1994;13:763–766
  48. Lilja M. Infants with single umbilical artery studied in a national registry. 2. Survival and malformations in infants with single umbilical artery. Paediatr. Perinat. Epidemiol. 1992;6:416–422
  49. Raio L, Ghezzi F, Di Naro E, Franchi M, Bruhwiler H, Luscher KP. Prenatal assessment of Wharton’s jelly in umbilical cords with single artery. Ultrasound Obstet. Gynecol. 1999;14:42–46
  50. Degani S, Lewinsky RM, Berger H, Spiegel D. Sonographic estimation of umbilical coiling index and correlation with Doppler flow characteristics. Obstet. Gynecol. 1995;86:990–993
  51. Di Naro E, Ghezzi F, Raio L, Franchi M, D’Addario V, Lanzillotti G, Schneider H. Umbilical vein blood flow in fetuses with normal and lean umbilical cord. Ultrasound Obstet Gynecol, in press.
  52. Reynolds SRM. Mechanisms of placentofetal blood flow. Obstet. Gynecol. 1978;51:245–249
  53. Lees C, Albaiges G, Deane C, Parra M, Nicolaides KH. Assessment of umbilical arterial and venous flow using color Doppler. Ultrasound Obstet. Gynecol. 1999;14:250–255
  54. Gill RW, Kossoff G, Warren PS, Garrett WJ. Umbilical venous flow in normal and complicated pregnancy. Ultrasound Med. Biol. 1984;10:349–363
  55. Challis DE, Warren PS, Gill RW. The significance of high umbilical and venous blood flow measurements in a high-risk population. J. Ultrasound Med. 1995;14:907–912

PII: S0301-2115(00)00470-X

European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 96, Issue 2 , Pages 150-157 , June 2001

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