Effect of umbilical vein blood flow on perinatal outcome of fetuses with lean and/or hypo-coiled umbilical cord
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- El behery, M.M., Nouh, A.A., Alanwar, A.M. et al. Arch Gynecol Obstet (2011) 283: 53. doi:10.1007/s00404-009-1272-0
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To evaluate the effect of umbilical vein (UV) blood flow measured by color-directed pulsed-wave Doppler on perinatal outcome of fetuses with lean and/or hypocoiled umbilical cord after 24 weeks of gestation.
Two hundred and forty-four women with singleton fetus after 24 weeks of gestation were studied. Umbilical cord area, umbilical vessel cross-sectional area and antenatal umbilical coiling index (UCI) were calculated and compared with Doppler parameters including UV blood flow volume in ml/min/kg, UV peak systolic velocity in cm/s, and umbilical artery pulsatility index.
Thirty-eight (15.5%) fetuses had lean umbilical cord (area < 10th percentile). A significant difference between fetuses with and those without lean cord was found in terms of: UCI (0.17 ± 0.06 vs. 0.35 ± 0.08, P < 0.001), cord cross-sectional area (89.6 ± 11.7 vs. 198.7 ± 33.7 mm2, P < 0.001), Wharton’s jelly amount (36.5 ± 11.2 vs. 125.2 ± 34.1 mm2, P < 0.001), UV blood flow (83.4 ± 15.8 vs. 131.0 ± 19.8 ml/min/kg, P < 0.001), and UV blood flow mean velocity (8.6 ± 3.7 vs. 12.1 ± 2.8 cm/s, P < 0.05). A significant positive correlation was found between antenatal UCI and UV blood flow (r = 0.73, P < 0.001).
Fetuses with lean and/or hypo-coiled umbilical cord showed a noticeable decrease in UV blood flow of sufficient magnitude that could affect fetal growth, and this could explain the higher prevalence of fetal intrapartum complications in growth-restricted fetuses.