Effect of umbilical vein blood flow on perinatal outcome of fetuses with lean and/or hypo-coiled umbilical cord.
OBJECTIVE
To evaluate the effect of umbilical vein (UV) blood flow measured by color-directed pulsed-wave Doppler on perinatal outcome of fetuses with lean and/or hypocoiled umbilical cord after 24 weeks of gestation.


METHODS
Two hundred and forty-four women with singleton fetus after 24 weeks of gestation were studied. Umbilical cord area, umbilical vessel cross-sectional area and antenatal umbilical coiling index (UCI) were calculated and compared with Doppler parameters including UV blood flow volume in ml/min/kg, UV peak systolic velocity in cm/s, and umbilical artery pulsatility index.


RESULTS
Thirty-eight (15.5%) fetuses had lean umbilical cord (area < 10th percentile). A significant difference between fetuses with and those without lean cord was found in terms of: UCI (0.17 ± 0.06 vs. 0.35 ± 0.08, P < 0.001), cord cross-sectional area (89.6 ± 11.7 vs. 198.7 ± 33.7 mm(2), P < 0.001), Wharton's jelly amount (36.5 ± 11.2 vs. 125.2 ± 34.1 mm(2), P < 0.001), UV blood flow (83.4 ± 15.8 vs. 131.0 ± 19.8 ml/min/kg, P < 0.001), and UV blood flow mean velocity (8.6 ± 3.7 vs. 12.1 ± 2.8 cm/s, P < 0.05). A significant positive correlation was found between antenatal UCI and UV blood flow (r = 0.73, P < 0.001).


CONCLUSIONS
Fetuses with lean and/or hypo-coiled umbilical cord showed a noticeable decrease in UV blood flow of sufficient magnitude that could affect fetal growth, and this could explain the higher prevalence of fetal intrapartum complications in growth-restricted fetuses.
El Behery
Manal M
MM
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. mbhry@hotmail.com
Nouh
Amal A
AA
Alanwar
Amal M
AM
Diab
Abdalla E
AE
D000328:Adult; D001724:Birth Weight; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D005333:Fetus / Q000002:abnormalities* / Q000098:blood supply*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D014470:Umbilical Cord / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult