Relationship between sonographic umbilical cord size and gestational age among pregnant women in Enugu, Nigeria

Morphometric Evaluation of Human Placental and Umbilical Cord for Neonatal Indices: A Cross-Sectional Study

BACKGROUND

In India, there is only limited data on studies related to umbilical cord and placental indices in newborn infants. The present study was undertaken to evaluate the morphometric analysis of placental and umbilical cord indices and their association with length, weight, and head size in newborns.

MATERIALS AND METHODS

This was a longitudinal cross-sectional study conducted on placentas and fetal measures from 245 women who gave birth during the study period. The placental variables, umbilical cord indices, and neonatal indices were measured. The association between the parameters was done using Pearson's correlation, and p<0.05 was considered statistically significant.  Results: The placental weight (p=0.01) and placental volume (p=0.01) showed a significant positive correlation with newborn weight. The mean placental diameter was 16.32 ± 1.54 cm, and there was no significant correlation between placental diameter and infant weight (p=0.232), length (p=0.658), or head circumference (0.842). In addition, there was a significant association between placental diameter, placental volume (p=0.000), and placental weight (p=0.000). There was a significant positive correlation (p<0.05) between ponderable index and birth weight, length, and head circumference.

CONCLUSION

Placental weight and newborn weight were significantly associated in this study. The length of the umbilical cord was found to be related to placental weight. So, placental measurements are reliable indicators for the assessment of fetal wellbeing.

Sonographic Assessment of Umbilical Cord Diameter as an Indicator of Fetal Growth and Perinatal Outcome

Objective:

To determine whether the assessment of umbilical cord diameter (UCD) is a viable indicator of fetal growth and perinatal outcome.

Material and Methods:

A total of 652 singleton pregnancies between 10 and 40 weeks of gestation were reviewed for this study. The UCD was measured vertically in the longitudinal section, adjacent to its insertion at the fetal abdomen. Other fetal biometrics were measured according to standard measurement protocols. The perinatal outcome of each patient case was also recorded.

Result:

The UCD ranged between 0.73 and 1.68 cm, and correlated positively with gestational age, estimated fetal weight ( r = 0.779, r = 0.639, P < .05), and other fetal biometrics. The UCD of 50 subjects was 2 standard deviations below the mean and correlated significantly ( r = 0.712, P < .05) with poor fetal outcome in the first and second trimester. Observational studies of 50 subjects, whose UCD was 2 standard deviations below the mean, resulted in 21 cases of intrauterine fetal death, 10 cases of preeclampsia, 8 cases of oligohydramnios, and 11 cases of intrauterine growth restriction.

Conclusion:

The UCD has the potential to serve as an important indicator of fetal growth, well-being, and perinatal outcome.

Correlations between the Status of the Umbilical Cord and Neonatal Health Status

Purpose: This study aimed to identify correlations between the status of the umbilical cord and neonatal health status.Methods: In total, 172 newborns were enrolled who were admitted to the newborn nursery with a gestational age of 35 weeks or older and a body weight of 2 kg or above. Data were collected on the basic personal information of the newborns, the diameter and soft tissue status of the umbilical cord, and neonatal health status after birth. Analyses were performed using t-test, analysis of variance, <i>x</i>² test, and Fisher exact test.Results: Umbilical cord diameter exhibited a statistically significant difference by sex (t=2.71, <i>p</i>=.007). A thin umbilical cord diameter was associated with a 1-minute Apgar score less than 8 points (t=2.47, <i>p</i>=.015) and with being transferred to the intensive care unit (t=2.45, p=.015). Poor soft tissue status of the umbilical cord was associated with a 1-minute Apgar score of less than 8 points (<i>x</i>²=16.68, <i>p</i><.001) and with oxygen being supplied (<i>x</i>²=4.81, <i>p</i>=.028).Conclusion: Assessing the umbilical cord diameter and status in newborns is an important tool for evaluating neonatal health status after birth, and this point also underscores the importance of professionals' careful observations in the newborn nursery.

Sonographic Estimation of Umbilical Cord Cross-section Area and its Reference Value in Normal Pregnancy

INTRODUCTION

The routine antenatal sonographic investigations of the umbilical cord are limited for assessment of number of umbilical vessels and doppler evaluation of umbilical blood flow. With the advancements of the sonographic techniques it is now possible to have more detailed evaluation of umbilical cord. There exist only few literatures on assessment of umbilical cord cross-sectional area during pregnancy to provide a baseline reference value.

AIM

To establish the reference intervals of cross-sectional area of the umbilical cord during gestation and to find the correlation of umbilical cord cross-sectional area with the foetal anthropometric measurements.

MATERIALS AND METHODS

This study was conducted among 214 normal pregnant women who underwent a routine antenatal sonogram during gestational age ranging from 24-39 weeks in the Department of Radiodiagnosis. The umbilical cord cross-sectional area was calculated at a plane immediately close to the umbilical cord insertion to the foetal abdomen. The following foetal parameters were studied: Biparietal Diameters (BPD), Head Circumference (HC), Abdominal Circumference (AC), Femur Length (FL), and Estimated Foetal weight (EFW). The relationship between foetal anthropometric measurements and umbilical cord cross sectional area was assessed using spearman rank correlation. The 5^th, 10^th, 50^th, 90^th and 95^th percentiles of umbilical cord cross-sectional area were calculated for each gestational groups using polynomial regression analysis.

RESULTS

A statistically significant correlation was observed between cross-sectional area of umbilical cord with both gestational age and foetal anthropometric parameters. The mean age of study population was 25.08±3.5 years and the mean gestational age was 34.42±2.5 weeks. We observed a strong correlation between head circumference and umbilical cord cross-sectional area.

CONCLUSION

The mean umbilical cord cross-section area increases steadily with gestational age for up to 34 weeks and then it declines. Umbilical cord cross-sectional area can be easily measured and hence it can be included in routine antenatal sonographic evaluations to predict the perinatal outcome. Careful monitoring of the pregnancy is needed in case of abnormal cross-sectional area measurements.