First-trimester sonographic umbilical cord diameter and the growth of the human embryo

Objectives Experimental and clinical evidence have shown that the morphomet ry of the umbilical cord in the second half of gestation might be useful in predicting adverse perinatal outcome. The purposes of this study were to g enerate a nomogram for the umbilical cord diameter in the first trimester a nd, in an observational study, to investigate whether the sonographic measu rement of the umbilical cord diameter early in gestation has the same clini cal value as that late in gestation. Methods The sonographic umbilical cord diameter, crown-rump length and bipa rietal diameter were measured in 439 fetuses at between 8 and 15 weeks of g estation. The perinatal outcome was recorded for all patients. Results The umbilical cord diameter increased steadily from 8 to 15 weeks o f gestation. A significant correlation was found between umbilical cord dia meter and gestational age (r = 0.78; p < 0.001), umbilical cord diameter an d crown-rump length (r = 0.75; P < 0.001) and umbilical cord diameter and b iparietal diameter (r = 0.81, P < 0.001). No correlation was found between umbilical cord diameter values and either birth weight or placental weight. Among patients who had a miscarriage (n = 7) and pre-eclampsia (n = 8) the umbilical cord diameter was below 2 standard deviations from the mean in t b ree cases (42.9 %) and th ree cases (37.5 %), respectively. Conclusion The measurement of the umbilical cord diameter in the first trim ester is correlated with the growth of the embryo and may be a marker for i dentifying a subset of fetuses at risk of spontaneous miscarriage and pre-e clampsia.