Altered sonographic umbilical cord morphometry in early-onset preeclampsia.
OBJECTIVE
To determine whether the sonographic morphometry of the umbilical cord components is different in preeclamptic compared with healthy pregnant women.


METHODS
Consecutive women admitted after 20 weeks' gestation with the diagnosis of preeclampsia and whose fetus was normally grown (cases) were included in the study. Each case was matched to a healthy pregnant woman (controls) who had ultrasonography at the same gestational age (+/- 3 days). The sonographic cross-sectional areas of the umbilical cord and umbilical vessels were obtained in all patients and plotted on reference ranges. The umbilical artery resistance index was measured in all patients with preeclampsia.


RESULTS
Twenty-five preeclamptic women were enrolled. The proportion of cases with a lean (below the tenth centile) umbilical cord was higher in cases than in controls (12 of 25 versus 1 of 25, P <.001). The Wharton's jelly area was lower in cases than in controls (median 105.8 mm(2) [range 49.6-212.9 mm(2)] versus 138.7 mm(2) [79.7-226.6 mm(2)], P =.024). The umbilical vein area was less in cases than in controls (median 29.2 mm(2) [range 8.0-52.8 mm(2)] versus 37.4 mm(2) [13.8-70.8 mm(2)], P =.032). The proportion of patients with a lean umbilical cord was higher among those with early-onset preeclampsia than in those with late-onset preeclampsia (12 of 19 versus 0 of 6, P =.014).


CONCLUSIONS
Early-onset preeclampsia frequently is associated with reduced Wharton's jelly area and umbilical vein area compared with normal pregnancy. Sonographic umbilical cord morphometry might have clinical value for prompt identification of women at risk for preeclampsia.
Raio
Luigi
L
Department of Obstetrics and Gynecology, University of Berne-Inselspital, Bern, Switzerland. luigi.raio@insel.ch
Ghezzi
Fabio
F
Di Naro
Edoardo
E
Franchi
Massimo
M
Bolla
Daniele
D
Schneider
Henning
H
D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005314:Embryonic and Fetal Development / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D014470:Umbilical Cord / Q000000981:diagnostic imaging* / Q000473:pathology*; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000473:pathology