A physics approach to the consequences of excess umbilical cord length
DOI:
https://doi.org/10.18597/rcog.8Keywords:
Stillborn, umbilical cord, thrombosis, physicsAbstract
Introduction: Despite its role of transporting all the things that a foetus needs to grow and survive, the umbilical cord is still poorly understood. All of its characteristics are relevant, and paramount among them is its length. When abnormal, length is associated with poor neurological prognosis and foetal demise.
Materials and methods: Based on a review of physics principles, formulae were proposed in an attempt to explain the importance of umbilical cord length on the basis of its haemodynamic repercussions.
Results: Foetal circulation was analysed from the heart to the placental villous capillaries and physics formulae were used to describe the importance of umbilical cord length in foetal perfusion.
Conclusions: Clinical complications known to be associated with excess umbilical cord length were analysed from the physics perspective, and formulae were established for use with real data derived from foetal Doppler scans and umbilical cord measurements.
Author Biographies
Mercedes Olaya-Contreras
William Vargas-Moreno
Jaime Eduardo Bernal-Villegas
References
Ji Q, Luo ZX, Yuan CX, Wible JR, Zhang JP, Georgi JA. The earliest known eutherian mammal. Nature. 2002;416:816-22.
Wildman DE, Chen C, Erez O, Grossman LI, Goodman M, Romero R. Evolution of the mammalian placenta revealed by phylogenetic analysis. Proc Natl Acad Sci USA. 2006;103:3203-8.
Wang Y, Zhao S. Placental Blood Circulation. En: Wang Y, Zhao S. Vascular Biology of the Placenta. San Rafael (CA): Morgan & Claypool Life Sciences; 2010. p. 3-11.
Lewis S, Benirschke K. Placenta. En: Mills S. Histology for Pathologists. Third edition. Philadelphia: Lippincott Williams and Wilkins; 2007. p. 1095-126.
Blackburn W. Umbilical cord. In: Stevenson RE, Hall JG. Human malformation and related anomalies. 2nd ed. New York: Oxford University Press; 2006. p. 1413-95.
Tantbirojn P, Saleemuddin A, Sirois K, Crum C, Boyd T, et al. Gross Abnormalities of the umbilical cord: Related Placental Histology and Clinical Significance. Placenta. 2009;30:1083-8.
Horn LC, Langner A, Stiehl P, Wittekind C, Faber R. Identification of the causes of intrauterine death during 310 consecutive autopsies. Eur J Obstet Gynecol Reprod Biol. 2004;113:134-8.
Collins JH, Collins CL, Collins CC. Silent risk - Issues about the Human Umbilical Cord. Umbilical cord accidents; 2010. [Visitado 2012 Nov 10]. Disponible en: http://www.preginst.com/pucp.html
Stefos T, Sotiriadis A, Vasilios D, Tsirkas P,Korkontzelos I, Avgoustatos F. et al. Umbilical cord legth and paritythe Greek experience. Eur J Obstet Gynecol Reprod Biol. 2003;107:41-4.
Benirschke K, Burton G, Baergen R. Anatomy and pathology of the umbilical cord. En: Bernirschke K, Burton G, Baergen R. Pathology of the human placenta. 6th ed. New York: Springer; 2012. p. 309-76.
Olaya CM, Bernal JE. Comprendiendo el cordón umbilical. Patología Rev Latinoam. 2013;51:200-5.
Donlon CR, Furdon SA, Clark DA. Look before you clamp: delivery room examination of the umbilical cord. Adv Neonatal Care. 2002;2:19-26.
Ferguson VL, Dodson RB. Bioengineering aspects of the umbilical cord. Eur J Obstet Gynecol Reprod Biol. 2009;144:S108-13.
Ernst L. Placenta. En: Ernst L, Ruchelli E, Huff DS, editors. Color Atlas of Fetal and Neonatal Histology. Chicago: Springer; 2011. p. 363-88.
Baergen RN. Pathology of the Umbilical Cord in Baergen RN. Manual of and Kaufmann’s Pathology of the Human Placenta. Second Edition. New York: Springer; 2011. p. 247-80.
Kraus FT, Redline R, Gersell D, Nelson M, Dicke J. Anatomy, Structure, Development, and function. Placental Pathology. Washington, DC: American Registry of Pathology, Atlas of nontumor pathology, First series, Fascicle 3; 2004. p. 1-22.
Kalish R, Hunter T, Sharma G, Baergen R. Clinical significance of the umbilical cord twist. Am J Obstet Gynecol. 2003;189:736-9.
Hernández E, Benavides-Serralde, Cruz-Martínez R, Gratacós E. Conceptos esenciales sobre las bases físicas del Doppler para su utilización clínica. En: Gratacós E, Figueras F, Hernández E, Puerto B. Doppler en Medicina Fetal. Madrid: Editorial Médica Panamericana; 2010. p. 1-32.
Mortera C. Ecocardiografía fetal. Anatomía y fisiología normal del feto. En: Protocolos diagnósticos y terapéuticos en cardiología pediátrica. Unidad de Cardiología Pediátrica, Hospital San Juan de Dios, HCP. Barcelona. [Visitado 2013 Nov 15]. Disponible en: https://www.aeped.es/sites/default/files/documentos/37_eco_fetal.pdf
Balkawade NU, Shinde MA. Study of Length of Umbilical Cord and Fetal Outcome: A Study of 1,000 Deliveries. J Obstet Gynaecol India. 2012;62:520-5.
Chan JS, Baergen RN. Gross umbilical cord complications are associated with placental lesions of circulatory stasis and fetal hypoxia. Pediatr Dev Pathol. 2012;15:487-94.
Grafe MR. The correlation of prenatal brain damage with placental pathology. J Neuropathol Exp Neurol. 1994;53:407-15.
Baergen R. Cord abnormalities, structural lesions, and cord “accidents”. Semin Diagn Pathol. 2007;24:23-32.
Baergen RN, Malicki D, Behling C, Benirschke K. Morbidity, mortality, and placental pathology in excessively long umbilical cords: retrospective study. Pediatr Dev Pathol. 2001;4:414-53.
Redline RW. Clinical and pathological umbilical cord abnormalities in fetal thrombotic vasculopathy. Hum Pathol. 2004;35:1494-8.
Taweevisit M, Thorner PS. Massive fetal thrombotic vasculopathy associated with excessively long umbilical cord and fetal demise: case report and literature review. Pediatr Dev Pathol. 2010;13:112-5.
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