TY - JOUR
T1 - Impact of umbilical cord length on fetal circulatory system by Doppler assessment
AU - Olaya-C, Mercedes
AU - Vargas, William
AU - Martinez, Rodolfo Andres
AU - Peñaloza, Ivan Felipe
AU - Sanchez, Melissa
AU - Madariaga, Ithzayana
AU - Aldana, Sergio
AU - Bernal, Jaime E.
N1 - Publisher Copyright:
© 2020, Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Introduction: Numerous studies have revealed the impact of umbilical cord (UC) length on fetal perfusion; abundant data implicate abnormal UC length to neurological delay and subsequent poor prognoses for fetuses and newborns. Indeed, our group previously developed theoretical approximations that contributed to formulas capable of explaining the impact of UC length on cardiac output. Methods: We performed an observational study that measured the pulsatility index and flow velocity in umbilical arteries. A special Doppler measured proximal and distal indexes in both arteries. After birth, medical staff measured complete UC length. We obtained maternal and neonatal outcomes from clinical records. Results: Our study enrolled 20 pregnant mothers. We found that flow velocities in the two edges were different: fetal edges exhibited greater velocity in the majority of cases; but, when we compared pressure differentials (ΔP), the pulsatility index was significantly related to umbilical cord length. Conclusions: Fetal perfusion, welfare, and viability are related to UC function as the conveyor of all fetal volemia. Excessive UC length affects cardiac dynamics and increases peripheral vascular resistance. Further studies could validate routine use of the differential proximal and distal measurements proposed in this article, and their implications in in utero fetal heart function. We also hope that early diagnosis or UC alterations could alert neonatologists and obstetricians to clinical conditions of the fetus.
AB - Introduction: Numerous studies have revealed the impact of umbilical cord (UC) length on fetal perfusion; abundant data implicate abnormal UC length to neurological delay and subsequent poor prognoses for fetuses and newborns. Indeed, our group previously developed theoretical approximations that contributed to formulas capable of explaining the impact of UC length on cardiac output. Methods: We performed an observational study that measured the pulsatility index and flow velocity in umbilical arteries. A special Doppler measured proximal and distal indexes in both arteries. After birth, medical staff measured complete UC length. We obtained maternal and neonatal outcomes from clinical records. Results: Our study enrolled 20 pregnant mothers. We found that flow velocities in the two edges were different: fetal edges exhibited greater velocity in the majority of cases; but, when we compared pressure differentials (ΔP), the pulsatility index was significantly related to umbilical cord length. Conclusions: Fetal perfusion, welfare, and viability are related to UC function as the conveyor of all fetal volemia. Excessive UC length affects cardiac dynamics and increases peripheral vascular resistance. Further studies could validate routine use of the differential proximal and distal measurements proposed in this article, and their implications in in utero fetal heart function. We also hope that early diagnosis or UC alterations could alert neonatologists and obstetricians to clinical conditions of the fetus.
KW - Physics
KW - Stillbirth
KW - Thrombosis
KW - Umbilical cord
KW - Umbilical cord length
UR - http://www.scopus.com/inward/record.url?scp=85087768477&partnerID=8YFLogxK
U2 - 10.1007/s40477-020-00495-2
DO - 10.1007/s40477-020-00495-2
M3 - Article
C2 - 32654041
AN - SCOPUS:85087768477
SN - 1971-3495
VL - 23
SP - 585
EP - 592
JO - Journal of Ultrasound
JF - Journal of Ultrasound
IS - 4
ER -