| Prenatal diagnosis of a lean umbilical cord: a simple marker for the fetus at risk of being small for gestational age at birth. | |
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MedLine Citation:
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PMID: 10204208 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to investigate whether the prenatal diagnosis of a 'lean' umbilical cord in otherwise normal fetuses identifies fetuses at risk of being small for gestational age (SGA) at birth and of having distress in labor. The umbilical cord was defined as lean when its cross-sectional area on ultrasound examination was below the 10th centile for gestational age. METHOD: Pregnant women undergoing routine sonographic examination were included in the study. Inclusion criteria were gestational age greater than 20 weeks, intact membranes, and singleton gestation. The sonographic cross-sectional area of the umbilical cord was measured in a plane adjacent to the insertion into the fetal abdomen. Umbilical artery Doppler waveforms were recorded during fetal apnea and fetal anthropometric parameters were measured. RESULTS: During the study period, 860 patients met the inclusion criteria, of whom 3.6% delivered a SGA infant. The proportion of SGA infants was higher among fetuses who had a lean umbilical cord on ultrasound examination than among those with a normal umbilical cord (11.5% vs. 2.6%, p < 0.05). Fetuses with a lean cord had a risk 4.4-fold higher of being SGA at birth than those with a normal umbilical cord. After 25 weeks of gestation, this risk was 12.4 times higher when the umbilical cord was lean than when it was of normal size. The proportion of fetuses with meconium-stained amniotic fluid at delivery was higher among fetuses with a lean cord than among those with a normal umbilical cord (14.6% vs. 3.1%, p < 0.001). The proportion of infants who had a 5-min Apgar score < 7 was higher among those who had a lean cord than among those with normal umbilical cord (5.2% vs. 1.3%, p < 0.05). Considering only patients admitted in labor with intact membranes and who delivered an appropriate-for-gestational-age infant, the proportion of fetuses who had oligohydramnios at the time of delivery was higher among those who had a lean cord than among those with a normal umbilical cord (17.6% versus 1.3%, p < 0.01). CONCLUSION: We conclude that fetuses with a lean umbilical cord have an increased risk of being small for gestational age at birth and of having signs of distress at the time of delivery. |
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Authors:
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L Raio; F Ghezzi; E Di Naro; M Franchi; E Maymon; M D Mueller; H Brühwiler |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 13 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 1999 Mar |
Date Detail:
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Created Date: 1999-05-28 Completed Date: 1999-05-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 176-80 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Kantonsspital, Münsterlingen, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniotic Fluid / chemistry Anatomy, Cross-Sectional Apgar Score Confidence Intervals Female Fetal Distress / etiology Gestational Age Humans Infant, Newborn Infant, Small for Gestational Age* Labor, Obstetric Meconium / chemistry Oligohydramnios / complications Pregnancy Risk Factors Sensitivity and Specificity Ultrasonography, Doppler Ultrasonography, Prenatal* Umbilical Arteries / ultrasonography Umbilical Cord / ultrasonography* |
| Comments/Corrections | |
Comment In:
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Ultrasound Obstet Gynecol. 1999 Mar;13(3):157-60
[PMID:
10204204
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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