title: Comprehensive imaging review of abnormalities of the umbilical cord.
abstract: A complete fetal ultrasonographic (US) study includes assessment of the umbilical cord for possible abnormalities. Knowledge of the normal appearance of the umbilical cord is necessary for the radiologist to correctly diagnose pathologic conditions. Umbilical cord abnormalities can be related to cord coiling, length, and thickness; the placental insertion site; in utero distortion; vascular abnormalities; and primary tumors or masses. These conditions may be associated with other fetal anomalies and aneuploidies, and their discovery should prompt a thorough fetal US examination. Further workup and planning for a safe fetal delivery may include fetal echocardiography and karyotype analysis. Doppler US is a critical tool for assessment and diagnosis of vascular cord abnormalities. US also can be used for follow-up serial imaging evaluation of conditions that could result in fetal demise. Recent studies suggest that three- or four-dimensional Doppler US of the fetal umbilical cord and abdominal vasculature allows more accurate diagnosis of vascular abnormalities. Doppler US also is invaluable in assessment of fetal growth restriction since hemodynamic changes in the placenta or fetus would appear as a spectral pattern of increased resistance to forward flow in the fetal umbilical artery. Early detection of umbilical cord abnormalities and close follow-up can reduce the risk of morbidity and mortality and assist in decision making.
authors.affiliation: From the Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195 (M.M., S.F.Z., T.J.R., P.B., T.J.D.); Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (P.B.); Department of Laboratories, Seattle Children's Hospital, Seattle, Wash (J.R.S.); and Department of Radiology, Winthrop-University Hospital, Mineola, NY (D.S.K.).
authors.forename: Mariam
authors.initials: M
authors.lastname: Moshiri
authors.forename: Sadaf F
authors.initials: SF
authors.lastname: Zaidi
authors.forename: Tracy J
authors.initials: TJ
authors.lastname: Robinson
authors.forename: Puneet
authors.initials: P
authors.lastname: Bhargava
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Siebert
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Dubinsky
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Katz
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D053589:Nuchal Cord / Q000000981:diagnostic imaging*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014470:Umbilical Cord / Q000002:abnormalities* / Q000098:blood supply / Q000000981:diagnostic imaging*; D014496:Urachal Cyst / Q000000981:diagnostic imaging*; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging*