Reference intervals for the cross sectional area of the umbilical cord during gestation
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Fernando Alves Togni
Abstract
Objective: To establish reference values for the sonographic cross-sectional area of the umbilical cord during gestation and to correlate them with fetal anthropometric parameters.
Methods: A cross-sectional study was performed involving 312 normal pregnant women at gestational ages 24–39 weeks. Measurement of the cross-sectional area of umbilical cord was performed on a plane adjacent to the insertion of the cord into fetal abdomen. The following anthropometric parameters were calculated: biparietal diameter, head circumference, abdominal circumference and femur length. A polynomial regression analysis identified the curves that were better adjusted to the average and standard deviation according to gestational age. Spearman correlation was used to evaluate the correlation of the cross-sectional area of umbilical cord with fetal anthropometric parameters.
Results: A statistically significant correlation was observed between the cord cross-sectional area and gestational age (r=0.376, P<0.001, CI 95%[0.276; 0.467]).
Conclusions: The reference values of the cross-sectional area of umbilical cord increased according to gestational age until the 33rd week and are related to parameters of fetal growth.
References
1 Arduini D, G Rizzo: Normal values of Pulsatility Index from fetal vessels: a cross-sectional study of 1556 healthy fetuses. J Perinat Med18 (1990) 165Search in Google Scholar
2 Cromi A, F Ghezzi, P Durig, E Di Naro, L Raio: Sonographic umbilical cord morphometry and coiling patterns in twin-to-twin transfusion syndrome. Prenat Diagn25 (2005) 851Search in Google Scholar
3 Cusi V: Desarrollo normal del embrión [Normal development of the embryo]. In: Career JM, A Kurjak (eds): Medicina del embrión, Masson, Barcelona 1967Search in Google Scholar
4 Dudiak CM, CG Salomon, HV Posniak, MC Olson, ME Flisak: Sonography of the umbilical cord. Raiographics15(1995) 103510.1148/radiographics.15.5.7501849Search in Google Scholar PubMed
5 Ghezzi F, L Raio, E Di Naro, M Franchi, D Balestredi, V D′Addario: Nomogram of Wharton's jelly as decipted in the sonographic cross section of the umbilical cord. Ultrasound Obstet Gynecol18 (2001) 121Search in Google Scholar
6 Ghezzi F, L Raio, DG Duwe, A Cromi, E Karousou, P Durig: Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord. J Clin Ultrasound33 (2005) 18Search in Google Scholar
7 Gill P, D Jarjoura: Wharton's jelly in the umbilical cord: a study of its quantitative variations and clinical correlates. J Reprod Med38 (1993) 611Search in Google Scholar
8 Hadlock FP, RB Harrist, J Martinez-Poyer: In utero analysis of fetal growth: a sonographic weight standard. Radiology181 (1991) 129Search in Google Scholar
9 Moore TR, JE Cayle: The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol162 (1990) 1168Search in Google Scholar
10 Nanaev AK, G Kohnen, AP Milovanov, SP Domogatsky, P Kaufmann: Stromal differentiation and architecture of the human umbilical cord. Placenta18 (1987) 53Search in Google Scholar
11 Phelan JP, CV Smith, P Broussard, M Small: Amniotic fluid volume assessment using the four-quadrant technique at 36–42 weeks' gestation. J Reprod Med32 (1987) 540Search in Google Scholar
12 Raio L, F Ghezzi, E Di Naro, DG Duwe, A Cromi, H Schneider: Umbilical cord morphologic characteristics and umbilical artery Doppler parameters in intrauterine growth-restricted fetuses. J Ultrasound Med22 (2003) 1341Search in Google Scholar
13 Raio L, F Ghezzi, E Di Naro, M Franchi, D Bolla, H Schneider: Altered sonographic umbilical cord morphometry in early-onset preeclampsia. Obstet Gynecol100 (2002) 311Search in Google Scholar
14 Raio L, F Ghezzi, E Di Naro, M Franchi, E Maymon, MD Mueller, et al.: Prenatal diagnosis of a lean umbilical cord: a simple marker for the fetus at risk of being small for gestational age at birth. Ultrasound Obstet Gynecol13(1999) 17610.1046/j.1469-0705.1999.13030176.xSearch in Google Scholar PubMed
15 Raio L, F Ghezzi, E Di Naro, R Gomez, M Franchi, M Mazor, et al.: Sonographic measurement of the umbilical cord and fetal anthropometric parameters. Eur J Obstet Gynecol Reprod Biol83 (1999) 131Search in Google Scholar
16 Skulstad SM, M Ulriksen, S Rasmussen, T Kiserud: Effect of umbilical ring constriction on Wharton's jelly. Ultrasound Obstet Gynecol28 (2006) 692Search in Google Scholar
17 Takechi K, Y Kuwabara, M Mizuno: Ultrastructural and immunohistochemical studies of Wharton's jelly umbilical cord cells. Placenta13 (1993) 235Search in Google Scholar
18 Vizza E, S Correr, V Goranova, R Heyn, PA Angelucci, R Forleo, et al.: The collagen skeleton of the human umbilical cord at term. A scanning electron microscopy study after 2N-NaOH maceration. Reprod Fertil Dev8 (1996) 885Search in Google Scholar
19 Weissman A, P Jakobi, M Bronshtein, I Golstein: Sonographic measurements of the umbilical cord and vessels during normal pregnancies. J Ultrasound Med13 (1994) 11Search in Google Scholar
20 Weissman A, P Jakobi: Sonographic measurements of the umbilical cord in pregnancies complicated by gestational diabetes. J Ultrasound Med16 (1997) 691Search in Google Scholar
©2007 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- To all readers, authors and subscribers
- The relationship between periodontal disease, bacterial vaginosis, and preterm birth
- Does raising the glucose challenge test threshold impact birthweight in Asian gravidas?
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