Umbilical Cord Complications and Perinatal Outcomes
Summary
Umbilical cord abnormalities constitute a significant contributor to perinatal morbidity and mortality worldwide. Common complications include abnormal cord length (excessively short or long), true knots, nuchal loops around the fetal neck and entanglement around the body. These conditions may impede blood flow, leading to fetal hypoxia, acid–base disturbances, growth restriction, stillbirth and, in some cases, long-term neurological sequelae. Risk factors encompass maternal characteristics (such as diabetes, high parity and increased body mass index), fetal factors (including male sex and polyhydramnios) and placental anomalies (such as velamentous or marginal insertion). Early detection through careful ultrasonographic assessment and targeted monitoring during labour can mitigate adverse outcomes. As obstetric practice advances, integrating standardised reference ranges for cord length, refined Doppler techniques and multidisciplinary counselling is essential to improve neonatal health and reduce perinatal loss.
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Umbilical Cord Complications and Perinatal Outcomes publication trend
The graph below shows the total number of articles in umbilical cord complications and perinatal outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Nuchal cord: A loop of umbilical cord wrapped around the fetal neck, which may compress vessels.
True knot of the umbilical cord: An actual knot formed in utero that can obstruct fetal circulation.
Umbilical artery pH: The acidity measurement of arterial blood in the umbilical cord, reflecting fetal acid–base status at birth.
Apgar score: A rapid assessment tool scored 0–10 evaluating a neonate’s appearance, pulse, grimace, activity and respiration at 1 and 5 minutes after birth.
Iatrogenic prematurity: Preterm birth resulting from medical intervention, often due to perceived fetal or maternal risk.
References
- Extreme umbilical cord lengths, cord knot and entanglement: Risk factors and risk of adverse outcomes, a population-based study. PLOS ONE (2018).
- The Strategy against Iatrogenic Prematurity Due to True Umbilical Knot: From Prenatal Diagnosis Challenges to the Favorable Fetal Outcome. Journal of Clinical Medicine (2022).
- The Significance of True Knot of the Umbilical Cord in Long-Term Offspring Neurological Health. Journal of Clinical Medicine (2020).
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