Umbilical cord abnormalities as a risk factor for pregnancy

Written by Szabó Béla, Turós János-Levente, Stupeczky Andrea Ildikó, Kiss Szilárd-Leó, Bereczky Lujza-Katalin, Puşcaşiu Lucian, Rozsnyai Florin Francisc

The umbilical cord is a very important organ in fetus development, in feto-placental circulation. In some cases with umbilical cord pathology, the circulation between placenta and fetus may decrease during labor. Any factor that affects the circulation in the umbilical cord can have very serious consequences to the fetus, even intrauterine death. Our study aims to establish to what extent is the umbilical cord pathology a risk factor during pregnancy and childbirth. We followed births in 2009 from the Department of Obstetrics and Gynecology I Târgu-Mures (2365 cases). We conducted a comparative study between pregnant women who had umbilical cord pathology and those who were without this pathology (control group). For statistical analysis we used the Chi-test. We found the umbilical cord pathology in 10,66% of births (single / double / triple circular belt around neck, true knot in cord). We found a statistically insignificant positive association between umbilical cord pathology and antepartum fetal death (1,58%. vs. 0,65%, RR = 2,283, p >0,05). We couldn’t find a significant increase in the rate of caesarean sections in the umbilical cord pathology group (27,38% vs. 24,8%, RR = 1,137, p >0:05). We noticed no difference between the two groups regarding low birth weight (9,64%. vs. 10,5%, RR = 0,964 p >0,05). We found positive associations between umbilical cord pathology and poor adaptation of the newborn at birth (Apgar 1-4: 4,14% vs. 1%, RR = 4,18, p >0,05) and with breech presentation (vs. 7: 44%. 3,5%, RR = 2,123, p >0,05). From our data, we can conclude the following: umbilical cord pathology is not an indication for caesarean section (with the exception of cord prolapse), but it requires a careful monitoring of pregnancy and childbirth.

 

Keywords: umbilical cord pathology, high risk pregnancy


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