Umbilical Cord Characteristics and Perinatal Outcomes
Summary
The umbilical cord is the vital lifeline connecting mother and fetus, typically comprising two arteries and one vein embedded within a gelatinous matrix known as Wharton’s jelly. Its morphometry, vascular arrangement and coiling patterns substantially influence fetal health and birth outcomes. Variations such as a single umbilical artery, supernumerary vessels, abnormal coiling or deficient Wharton’s jelly have been linked to complications ranging from intrauterine growth restriction and congenital anomalies to stillbirth and neonatal distress. Coiling, expressed by the umbilical coiling index, reflects vascular resilience and haemodynamic efficiency; hypo- or hypercoiling can predispose to cord compression or compromised blood flow. Nuchal cord entanglement, true knots and cord prolapse further underscore the dynamic interplay between cord architecture and foetal physiology. Advances in prenatal imaging and postnatal cord assessment have enriched our understanding of these features, informing risk stratification and monitoring protocols. Moreover, emerging computational and fluid dynamic models are elucidating the complex blood flow and heat exchange mechanisms within the cord, offering novel insights into early detection of perinatal risk. As research converges across clinical, imaging and engineering disciplines, a more nuanced framework for predicting and managing cord‐related perinatal outcomes is taking shape, with significant implications for global maternal and neonatal health.
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Umbilical Cord Characteristics and Perinatal Outcomes publication trend
The graph below shows the total number of articles in umbilical cord characteristics and perinatal outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Single umbilical artery (SUA): A cord variation in which one of the two umbilical arteries is absent, associated with increased risk of foetal anomalies and adverse outcomes.
Nuchal cord: One or more loops of umbilical cord wrapped around the foetal neck, which can affect blood flow and oxygen delivery.
Umbilical coiling index (UCI): A measure of the number of vascular coils per unit cord length, indicating vascular resilience and haemodynamic efficiency.
Wharton’s jelly: The mucoid connective tissue surrounding the umbilical vessels that protects them from compression.
Computational fluid dynamics (CFD): A mathematical modelling technique used to simulate blood flow and heat exchange within umbilical vessels.
References
- Aberrant Number of Vessels in the Umbilical Cord: What Do We Know?. Sci (2024).
- Umbilical cord characteristics and their association with adverse pregnancy outcomes: A systematic review and meta-analysis. PLOS ONE (2020).
- A computational fluid dynamics modelling of maternal-fetal heat exchange and blood flow in the umbilical cord. PLOS ONE (2020).
- Analysis of Umbilical Artery Hemodynamics in Development of Intrauterine Growth Restriction Using Computational Fluid Dynamics with Doppler Ultrasound. Bioengineering (2024).
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