Objective To investigate whether the amount of Wharton's jelly in non-malfo
rmed fetuses with a single umbilical artery is different front that of fetu
ses with a normal umbilical cord.
Methods WE evaluated patients with singleton pregnancies, non-malformed fet
uses and single umbilical artery undergoing sonographic evaluation as a ges
tational age ranging from 19 to 41 weeks' gestation. The cross-sessional ar
eas of the umbilical cord and of the umbilical vessels were measures. The a
mount of Wharton's jelly was calculated by subtracting from the total cross
-sectional area of the umbilical cord the areas of the artery and of the ve
in. The umbilical cord cross-sectional area, the umbilical artery and vein
areas ns well as the amount of Wharton's jelly rc,ere plotted on previously
published nomograms.
Results Twenty-two patients met the inclusion criteria. The umbilical cord
cross-sectional area was within the normal range in 20 (90.1%) cases. The u
mbilical artery and vein areas were above 2 standard deviations from the me
an in 20 cases and ill 11 cases (50%), respectively. The amount of Wharton'
s jelly tuns below 2 standard deviations from the mean in all cases. An abn
ormal insertion of the umbilical cord (marginal, velamentous) was present i
n five cases (22.7%).
Conclusions A reduction of Wharton's jelly is frequently present ill cases
of single umbilical artery The increased perinatal morbidity and mortality
observed in cases of single umbilical artery! even in the absence of congen
ital or chromosomal abnormalities, could be in ears the consequence of a re
duced amount of Wharton's jelly.