The umbilical cord
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  • 1. The Umbilical Cord
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  • 2. Anatomy
    Origin: It develops from the connecting stalk.
    Length: At term, it measures about 50 cm.
    Diameter: 2 cm.
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  • 3. Structure: It consists of mesodermal connective tissue called Wharton's jelly, covered by amnion. It contains:
    * one umbilical vein carries oxygenated blood from the placenta to the foetus,
    * two umbilical arteries carry deoxygenated blood from the foetus to the placenta,
    remnants of the yolk sac and allantois.
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  • 4. Insertion: The cord is inserted in the foetal surface of the placenta near the center "eccentric insertion" (70%) or at the center "central insertion" (30%).
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  • 5. Abnormalities of the Umbilical Cord
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  • 6. Abnormal cord insertion
    * Marginal insertion: in the placenta (battledore insertion).
    * Velamentous insertion: in the membranes and vessels connect the cord to the edge of the placenta. If these vessels pass at the region of the internal os, the condition is called " vasapraevia". Vasapraevia can occur also when the vessels connecting a succenturiate lobe with the main placenta pass at the region of the internal os.
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  • 7. Abnormal cord length
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  • 8. Short cord which may lead to:
    * intrapartumhaemorrhage due to premature separation of the placenta,
    * delayed descent of the foetus during labour,
    * inversion of the uterus.
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  • 9. Long cord which may lead to:
    * cord presentation and cord prolapse,
    * coiling of the cord around the neck,
    * true knots of the cord.
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  • 10. Knots of the cord
    * True knot: when the foetus passes through a loop of the cord. If pulled tight, foetal asphyxia may result.
    * False knot: localised collection of Wharton’s jelly containing a loop of umbilical vessels.
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  • 11. Torsion of the cord
    It may occur particularly in the portion near the foetus where the Wharton's jelly is less abundant.
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  • 12. Haematoma
    Due to rupture of one of the umbilical vessels.
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  • 13. Single umbilical artery
    It may be associated with other foetal congenital anomalies.
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