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Observational Study
. 2020 Dec;23(4):585-592.
doi: 10.1007/s40477-020-00495-2. Epub 2020 Jul 11.

Impact of umbilical cord length on fetal circulatory system by Doppler assessment

Mercedes Olaya-C  1   2 , William Vargas  3 , Rodolfo Andres Martinez  4   5 , Ivan Felipe Peñaloza  6   5 , Melissa Sanchez  6   5 , Ithzayana Madariaga  6   5 , Sergio Aldana  6   5 , Jaime E Bernal  7
Affiliations
Observational Study

Impact of umbilical cord length on fetal circulatory system by Doppler assessment

Mercedes Olaya-C et al. J Ultrasound. 2020 Dec.

Abstract

Introduction: Numerous studies have revealed the impact of umbilical cord (UC) length on fetal perfusion; abundant data implicate abnormal UC length to neurological delay and subsequent poor prognoses for fetuses and newborns. Indeed, our group previously developed theoretical approximations that contributed to formulas capable of explaining the impact of UC length on cardiac output.

Methods: We performed an observational study that measured the pulsatility index and flow velocity in umbilical arteries. A special Doppler measured proximal and distal indexes in both arteries. After birth, medical staff measured complete UC length. We obtained maternal and neonatal outcomes from clinical records.

Results: Our study enrolled 20 pregnant mothers. We found that flow velocities in the two edges were different: fetal edges exhibited greater velocity in the majority of cases; but, when we compared pressure differentials (ΔP), the pulsatility index was significantly related to umbilical cord length.

Conclusions: Fetal perfusion, welfare, and viability are related to UC function as the conveyor of all fetal volemia. Excessive UC length affects cardiac dynamics and increases peripheral vascular resistance. Further studies could validate routine use of the differential proximal and distal measurements proposed in this article, and their implications in in utero fetal heart function. We also hope that early diagnosis or UC alterations could alert neonatologists and obstetricians to clinical conditions of the fetus.

Keywords: Physics; Stillbirth; Thrombosis; Umbilical cord; Umbilical cord length.

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Figures

Fig. 1
Fig. 1
Impact of the UC length on the PI: relation between UC length and change in PI: the longer the UC, the greater the change in the index
See this image and copyright information in PMC

References

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