Umbilical cord morphology and pregnancy outcome

Traditionally. the prenatal assessment of the umbilical cord (UC) is limite d to the assessment of the number of vessels and to the evaluation of umbil ical artery blood flow parameters. Morphologic aspects of the UC have usual ly been studies by pathologists and retrospectively correlated with the per inatal outcome. The introduction of more sophisticated imaging techniques h ave offered the possibility to investigate the UC characteristics during fe tal life from early to late gestation. A number of investigations have demo nstrated that an altered structure of the UC can be associated with patholo gic conditions (i.e. Preeclampsia, fetal growth restriction, diabetes, feta l demise). Nomograms of the various UC components have been generated and a llow the identification of lean or large umbilical cords, entities frequent ly associated with fetal growth abnormalities and diabetes. A Wharton's jel ly reduction has also been invoked as a possible cause of fetal death in th e presence of single umbilical artery. Prenatal morphometric UC characteris tics as well as arterial and venous blood Bow parameters in normal and path ologic conditions will be discussed. (C) 2001 Elsevier Science ireland Ltd. All rights reserved.