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The umbilical cord


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The umbilical cord

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