Startseite The effect of nuchal umbilical cord on fetal cardiac and cerebral circulation-cross-sectional study
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The effect of nuchal umbilical cord on fetal cardiac and cerebral circulation-cross-sectional study

  • Julia Murlewska ORCID logo , Oskar Sylwestrzak , Przemysław Poszwa und Maria Respondek-Liberska
Veröffentlicht/Copyright: 11. Februar 2021

Abstract

Objectives

The subject of our analysis is the influence of umbilical cord collision around the fetal neck on the fetal heart function and cerebral circulation.

Methods

Our study was carried out on a group of 115 fetuses from single pregnancies with physiological course, during the 15th to 40th week of pregnancy. In our analysis, we examined the following parameters: Tei index for right ventricle, Tei index for left ventricle with Tei index components: isovolumetric contraction time, isovolumetric relaxation time, ejection time and cardiothoracic area ratio, middle cerebral artery peak systolic velocity (PS MCA), middle cerebral artery pulsatility index (PI MCA). Gestational age in our study was: 28+2±34. The study group of patients with fetal umbilical cord around neck group (fUCAN) included 38 fetuses (20 males, 18 females). The control group of patients with no fetal umbilical cord around neck group (NfUCAN) included 77 fetuses (43 males, 34 females).

Results

In our study, we found no significant differences in the values obtained: Tei LV in fUCAN: 0.5±0.1 vs. in NfUCAN: 0.5±0.1; p=0.42), Tei RV in fUCAN: 0.5±0.2 vs. in NfUCAN: 0.4±0.1; (p=0.2). Tricuspid valve regurgitation-TR was observed with the following frequency: fUCAN: 7/38, 18% vs. NfUCAN: 13/77, 17%; p=0.8. MCA PS in study fUCAN group was significantly higher than in NfUCAN (40.2±11.5 vs. 32.5±9.5; p=0.003), although other hemodynamic and clinical variables did not differ between the study and control groups.

Conclusions

The fetal nuchal umbilical cord collision did not affect the fetal heart function expressed as Tei index, at the time of fetal heart examination (at mean gestational age 29+4 weeks). The fUCAN group presented elevated PS MCA, which was not related to other hemodynamic and clinical variables between the study and control groups.


Corresponding author: Julia Murlewska, Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland; and Polish Prenatal Cardiology Society, Rzgowska Street 281/289, 93-338 Łódź, Poland, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was accepted by the Bioethics Committee (RNN/270/20/KE).

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Received: 2020-07-15
Accepted: 2020-12-10
Published Online: 2021-02-11
Published in Print: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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