Umbilical cord length and cord abnormalities in term singleton pregnancy: A Review of pregnancy outcome in a tertiary health institution in Nigeria

Authors

  • Charles Obinna Njoku Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital Calabar, Nigeria.
  • Patience Odusolu Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital Calabar, Nigeria.
  • Emechebe Cajetan Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital Calabar, Nigeria.
  • Emmanuel Ekanem Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital Calabar, Nigeria.
  • Amarachukwu Njoku Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital Calabar, Nigeria.

DOI:

https://doi.org/10.22317/jcms.v5i5.620

Keywords:

Umbilical cord, length, complications, obstetric outcome

Abstract

Objective: To determine the association of feto-maternal  outcomes  of term pregnancies with  fetal umbilical cord lengths and cord abnormalities in Calabar.

Methods:  A cross-sectional study of 600 women with singleton pregnancies who delivered either virginally or caesarean section between 37 and 42 completed weeks. Examination of cord was done at delivery for loop round neck, cord length, knots and cord abnormalities. Outcomes recorded include foetal presentation, sex,  birth weight, length of newborn and Apgar scores at 1st and 5th minutes. Also, mode of delivery, labour duration and maternal complications were noted.  Cords with abnormalities were sent for histological examination. Data was analyzed using SPSS version 20. Level of significance was set at p-value < 0.05.

Results:  The mean cord length was 61.07 ± 14.931cm, short  cords were 23(7.7%), long cords were 37 (12.3%) and 480 (80.0%) were normal length.  Male foetuses had longer cords,   mean cord length in the vertex presentations were significantly longer than in breech presentation and increased with increase in birth weight.  Abruptio placenta was higher among foetuses with short umbilical cord.  (17.4% vs 0.4%) (p-value-0.000).   There was positive correlation between foetal weight and umbilical cord length. Cord coiling index showed a negative correlation with cord length (r = -0.261; p-value = 0.000).

Conclusion: Abnormal umbilical cord lengths significantly predispose to obstetric complications but cord abnormalities are rare and does not affect pregnancy outcome.  High index of suspicion and careful evaluation of cord may inform and reduce untoward feto-maternal outcome

References

1. Kulkarni ML, Matadh PS, Ashok C, Pradeep N, Avinash T, Kulkarni AM. Absence of Wharton ’ s Jelly Around the Umbilical Arteries. Indian J Paed 2007;74(8):787–9.
2. Pathak, S., Hook, E., Hackett, G., Murdoch, E., Sebire, N. J., Jessop, F. and Lees CC. Cord coiling, umbilical cord insertion and placental shape in an unselected cohort delivering at term: relationship with common obstetric outcomes. Placenta. 2010;31:963–8.
3. Balkawade Nilesh Unmesh SMA. Study of Length of Umbilical Cord and Foetal Outcome : A Study of 1 , 000 Deliveries. J Obstet Gynecol India. 2012;62(5):520–5.
4. Yadav B.B, Kurdukar. D.V, Darade R.V MNA. Correlation of Umbilical Cord Length and Foetal Outcome. J Evol Meical Dent Sci. 2013;2(4):412–7.
5. Krakowiak P, Smith EN, Bruyn G De, Lydon-rochelle MT. Risk Factors and Outcomes Associated With a Short Umbilical Cord. Am Collge Obstet Gynecol. 2004;103(1):119–27.
6. Collins JH, Collins CJH. Umbilical cord accidents. Pregnancy Inst. 2012;7–8.
7. Lamonica GE, Wilson ML, Fullilove AM, Rayburn WF. Minimum Umblical Cord Length that Allows Spontaneous Vaginal Delivery. J Reprod Med. 2008;53(3):217–9.
8. Hershkovitz R, Silberstein T, Sheiner E, Shoham-Vardi I, Holcberg G, Katz M MM. Risk factors associated with true knots of the umbilical cord. Eur J Obs Gynecol Reprod Biol. 2001;98(1):36–9.
9. Scornes T. Umbilical cord knots. Acta Obs Gynecol Scand. 2000;79(3):157–9.
10. Sangwan V, Nanda S, Sangwan M, Malik R, Yadav M. Cord complications : associated risk factors and perinatal outcome. Open J Obstet Gynecol. 2011;1:174–7.
11. Marie Helen Beall, David Chelmow MGR. Umbilical Cord Complications. Medscape. 2014.
12. Collins CL. Umbilical Cord Accidents. Pregnancy Inst. 2010;1–84.
13. Ahmed M, Nuggedalla A. A preliminary study on the morphological variations in the umbilical cord Sundanese. Time J Med Sci Rep Res. 2013;1(2):10–5.
14. Agwu UM, Umeora OUJ, Ogbonnaya LU, Iyare FE, Obuna JA, Umahi VE. Foetal Umbilical Cord Length and Associated Intrapatum Complications In A Tertiary Institution, Southeast Nigeria. Ebonyi Med J. 2010;9(2):112–9.
15. Adesina KT, Ogunlaja OO, Aboyeji AP, Olarinoye OA, Adeniran AS. Umbilical cord parameters in Ilorin: correlates and foetal outcome. East Afr Med J. 2014;19(8):274–80.
16. Jaya D. S, Kumar Suresh N BSL. Anthropometric Indices, Cord Length and Placental Weight in Newborns. Indian J Paesiatrics. 1995;32(11):1183–8.
17. Stefos, T., Sotiriadis, A., Vasilios, D., Tsirkas, P., Korkontzelos, I., Avgoustatos F, Lolis D. Umbilical cord length and parity-the Greek experience. Eur J Obstet Gynecol Reprod Biol. 2003;107:41–4.
18. Samuel Bimpong. Qualitative Evaluation of Umbilical Cord and Placental Indices and Pregnancy Outcome (master’s thesis). Kwame Nkrumah University of Science and Technology, Kumasi; 2012.
19. Georgiadis L, Keski-Nisula L, Georgiadis S, Räisänen S, Harju M HS. Short umbilical cord – a risk factor for placental abruption ? 2014;35(4):2014.
20. Agboola A. Correlates of Human Umbilical Cord Length. Int J Gynaecol Obstet. 16(3):238–9.
21. Jick-Fuu Wu, Shiuh-Young Chang, Te-Yao Hsu, Chun-Hsien Hsieh, Fu-Tsai Kung et al. Multivariate analysis of the relationship between umbilical cord length and outcome. Chang Gung Med J. 1996;19(3):247–52.
22. Chitra T, Sushanth YS, Raghavan S. Umbilical coiling index as a marker of perinatal outcome: an analytical study. Obstet Gynecol Int. 2012 Jan;2012:1–6.
23. Ercal T, Lacin S, Altunyurt S, Saygili U, Cinar O MA. Umbilical coiling index: is it a marker for the foetus at risk? Br J Clin Pr. 1996;50(5):254–6.
24. Kashanian M, Akbarian A, Kouhpayehzadeh J. The umbilical coiling index and adverse perinatal outcome. Int J Gynaecol Obstet. 2006;95:8–13.
25. de Laat MW, Franx A, van Alderen ED, Nikkels PG VG. The umbilical coiling index, a review of the literature. J Matern Foetal Neonatal Med. 2005;17(2):93–100.
26. Appia PK. Relationship between the morphology of the placenta, umbilical cord and perinatal coutcome (master’s thsis). Kwame Nkrumah University of Science and Technology; 2009.
27. Martinez-Frias, M. L., Bermejo-Sanchez, E., Rodriguez-Pinilla, E. and Prieto-Merino D. Characteristics of neonates with and without a single umbilical artery. Analysis of two consecutive series of neonates with and without congenital defects. Ann Pediatr. 2006;65:541–50.

Downloads

Published

2019-10-26

How to Cite

Njoku, C. O., Odusolu, P., Cajetan, E., Ekanem, E., & Njoku, A. (2019). Umbilical cord length and cord abnormalities in term singleton pregnancy: A Review of pregnancy outcome in a tertiary health institution in Nigeria. Journal of Contemporary Medical Sciences, 5(5), 242–247. https://doi.org/10.22317/jcms.v5i5.620