Umbilical Cord Abnormalities and Maternal and Perinatal Outcome: A Prospective Observational Study
Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with t...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2021-04-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://www.jcdr.net/articles/PDF/14720/46830_CE[Ra1]_F[SK]_PF1(SC_SL)_PN(KM).pdf |
Summary: | Introduction: The umbilical cord is the vital extension of the
fetal circulatory system which regulates blood flow in both
directions, thus allowing mother-child communications viz.,
immunological, oxygenation, fetal nutrition, cardiac function.
Umbilical cord abnormalities are associated with the adverse
maternal and perinatal outcome..
Aim: To assess prevalence of various umbilical cord
abnormalities and its association with maternal complications
and perinatal outcome.
Materials and Methods: This prospective observational study
was conducted at Saraswathi Institute of Medical Sciences
Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till
March 2020. The approval for the study was taken from the
Institutional Ethical Committee. Total number of deliveries
during this period were 1284. After satisfying exclusion criteria,
total 600 deliveries of more than 37 weeks of gestation were
included in the study at random. Examination of cord was
done during delivery for presence of loops of cord around the
neck or body, any knots, true or false. After the delivery, the
cord was clamped 5 cm from the fetal end and the total length
was measured from the cut end till the placental insertion
site, and 5 cm added therein. Umbilical cord was examined
for any abnormalities and numbers of coils recorded and
Umbilical Coiling Index (UCI) measured. Apgar score and
NICU admissions noted.
Results: Out of 600 patients, umbilical cord abnormalities
were seen in 194 (32.33%) patients, while in 406 (67.67%) no
abnormality was detected. The mode of delivery was vaginal
in 441 cases (73.5%) while 159 (26.5%) had Lower Segment
Cesarian Section (LSCS). Out of 194 cases with umbilical cord
abnormality, 89 (45.87%) had LSCS and out of 406 cases
with no cord abnormality, only 70 cases (17.24%) had LSCS
(p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%)
had maternal complications and 143 cases (53.16%) had
umbilical cord abnormalities. While 126 (46.84%) cases with
maternal complications did not show any cord abnormality.
Apgar score of <7 at one minute was seen in 43 cases (22.16%)
and 23 (11.86%) were admitted in Neonatal Intensive Care Unit
(NICU) with umbilical cord abnormality.
Conclusion: The umbilical cord abnormalities were associated
with the adverse maternal and perinatal outcome and increased
rate of LSCS (p-value <0.0001). The study shows the importance
of knowledge of cord abnormalities. The cord abnormality
should be looked for after each delivery, with the aim to reduce
perinatal morbidity. |
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ISSN: | 2249-782X 0973-709X |