LINEA ALBA PIGMENTATION AND UMBILICAL DEVIATION IN NULLIPAROUS PREGNANCY - THE LIGAMENTUM TERES SIGN

Objective: To determine the incidence and direction of umbilical devia tion in pregnancy at term in nulliparas with linea alba pigmentation. Methods: All women attending one prenatal clinic over a period of 19 m onths were available. Subjects studied were the 315 nulliparas whose p regnancies had reached at least 37 weeks' gestation. The presence of l inea alba pigmentation, with or without umbilical flattening and/or de viation, was assessed with the woman lying symmetrically on her back o n an examination couch. Results: Forty-four of the 315 women (14%) had sufficient pigmentation for assessment; 27 of the 44 (61.4%) were bor n in Asia or the Indian subcontinent, although such women comprised on ly 13.5% of the clinic population. In 31 of the 44 women (70.5%), the umbilicus and supra- or infraumbilical linea nigra was deviated to the right side, and in 13 it remained in the midline; in none was there d eviation to the left side. Conclusion: Displacement of the umbilicus a nd adjacent structures commonly occurs in term pregnancy; pressure of the uterus on the ligamentum teres and falciform ligament determines t hat displacement is invariably toward the right side.