Placenta, Umbilical Cord, and Amniotic Membranes
Asim Kurjak in CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Developmental abnormalities are achordia, abnormal length of the cord, single umbilical artery, and supernumerary umbilical vessels.92 Theoretically, the achordia can be diagnosed by ultrasound, but this condition is very rare and is usually found only in aborted fetuses which were severely malformed. The average length of the umbilical cord is between 54 and 61 cm.83,93 The differences in length of the umbilical cord can be associated with a higher incidence of complications. By using ultrasound, it is not possible to measure the entire length of the umbilical cord, but some complications like the descensus of the umbilical cord or coiling umbilical cord, which are associated with its longer length, may be demonstrated.20
Fetal, Perinatal and Infant Autopsies
Julian L Burton, Guy Rutty in The Hospital Autopsy, 2010
The following measurements are important and should be compared with standard charts (Kraus et al., 2004). Placental weight (after trimming the cord and membranes). Two placental diameters should also be measured as well as the maximum placental thickness.Weight of any accompanying blood clot.Umbilical cord length. Short cords predispose to rupture; long cords predispose to entanglement.Feto-placental weight ratio (FPR). The placental nutrient supply to the fetus (dependent on the size, morphology, transporters and blood supply of the placenta) is a determinant of fetal growth. The FPR assesses placental efficiency and fetal growth. It increases from 4 at 25 weeks to 7 at term. Abnormal FPRs are related to abnormal fetal or placental weight (Langston et al., 1997). FPR values should be compared with standardised charts (Kraus et al., 2004).
Multiple choice questions (MCQs)
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon in Radiology for Undergraduate Finals and Foundation Years, 2018
Regarding obstetrical ultrasound, which of the following are true? The umbilical cord contains two arteries and one vein.The routine anomaly US scan is performed at 12 weeks.US-guided amniocentesis is performed earlier than chorionic villus sampling.IUGR is most accurately diagnosed by measuring the head circumference to abdominal circumference ratio.The crown-rump length is used in the second trimester.
Are Short Umbilical Cords Seen in Pathology Really Short?
Published in Fetal and Pediatric Pathology, 2018
Adanna Ukazu, Sitara Ravikumar, Natalie Roche, Debra S. Heller
The average umbilical cord length at term is between 50 and 60 cm (1), with short cords diagnosed when measuring less than 35 cm and long cords when measuring greater than 75 cm. Short umbilical cords have been shown to be associated with higher cesarean section rates, lower APGAR scores, and higher rates of neonatal intensive care admissions. Long umbilical cords, on the other hand, can be associated with fetal entanglement, true knots or thrombus formation in the cord and growth restriction in the fetus. While the accurate measurement of the total umbilical cord length is clinically significant, cords are rarely measured in the delivery room, and clinicians may rely on the Pathology Laboratory measurement. While the pathologist can diagnose a long cord, the receipt of a by-definition short cord by the pathologist doesn’t take into consideration that a portion of the cord may have been removed and sent for blood gas evaluation on the infant. This retrospective study sought to see if short umbilical cords as recorded by the pathologist are frequently associated with a segment removed for cord gases prior to submission to the Pathology Laboratory.
The residual blood from segmental umbilical cord milking in preterm delivery
Published in Journal of Obstetrics and Gynaecology, 2020
Woraphot Chaowawanit, Pruk Koovimon, Adjima Soongsatitanon
The demographic data including age, gestational age, risk factors, causes of preterm delivery was recorded. The standard management in preterm labour was provided to all participants. After delivery, the preterm infants were transferred to neonatal resuscitation unit before a segment of umbilical cord was immediately cut at approximately 2–3 cm from the umbilicus. A segment of umbilical cord was cut between 15 and 45 cm in length before placental delivery. A 15-cm clamp was implemented as a standard comparison. All parameters of the umbilical cord were measured by trained and validated data collectors. A standard measuring tape and Vernier callipers were used to determine a length and diameter of the umbilical cord. A circumference of the umbilical cord was measured by using a small thread around the umbilical cord and measured this thread by Vernier callipers. A standard scale was used for the placenta weight and the infant birth weights measurement. The umbilical cord was milked five times to collect blood. A 50 mL beaker was used with 1 mL scale for blood measurement.
Second trimester uterine rupture and repair followed by morbidly adherent placenta: a case report
Published in Journal of Obstetrics and Gynaecology, 2021
Claire Pintault, Aurore Bleuzen, Franck Perrotin, Caroline Diguisto
The ultrasound at 29 weeks showed a low-lying anterior placenta, with many venous lacunae suggestive of a morbidly adherent placenta (MAP). Magnetic resonance imaging and contrast-enhanced ultrasound were performed and both indicated placenta increta with suspected extension into the bladder (Figure 1). A multidisciplinary committee decided the time of birth and determined that the placenta increta should be managed conservatively (left in situ and monitored). After a course of antenatal corticosteroids, a caesarean by midline laparotomy was performed under general anaesthesia at 32 weeks of gestation. A transverse fundal incision made it possible not to transect the placenta, and a live boy weighing 1960 g was born. The umbilical cord was sectioned just above its site of insertion, and the placenta left in situ. The hysterotomy was closed by 2.0 Vicryl® sutures. Total blood loss was 700 mL. The patient’s clinical, laboratory and ultrasound follow-up was reassuring, with total placental resorption confirmed by ultrasound three months after birth.
Related Knowledge Centers
- Embryo
- Fetus
- Placenta
- Prenatal Development
- Artery
- Umbilical Artery
- Vein
- Umbilical Vein
- Wharton'S Jelly
- Oxygen