Umbilical cord abnormalities in fetal and neonatal pathology in Bogota

Introduction: Analysis was carried out on cases of fetal and perinatal mortality from 2007-2011, on fetuses and newborns in the Pathology Department at San Ignacio University Hospital (HUSI), in Bogota. Typical characteristics of the umbilical cord, their abnormalities and clinical outcomes were studied. Methods: A prospective study was performed for neonatal and fetal autopsies; placentas were also studied, and HUSI clinical cases were reviewed. Results: A total of 914 cases including fetuses, embryos, placentas and newborns made up the study. 323 cases (35.33%) had umbilical cord abnormalities: length abnormalities (7.87%): short (3.39%), long (4.48%); abnormal insertion (23.63%): velamentous (4.04%), furcate (0.43%), marginal- paramarginal (19.14%); coiled cords (6.01%): hypocoiled (0.65%), hypercoiled (5.36%); number of vessels (single umbilical artery) (0.43%); entanglements in fetal parts (0.54%); true knots (0.21%). In 4.81% more than one alteration was found: hypercoiled, the most frequent, appeared in six cases with marginal insertion, in five cases with long cords, in four cases with short cords. Cause of death attributable to umbilical cord (umbilical cord collision) occurred in 3.82%; there were thrombosis of the fetal circulation in 6,6%. Umbilical cord abnormalities were significantly associated with chromosomal abnormalities (p < 0.003, OR - 2.53), multiple gestations (OR - 5.78, 59.3%) and maternal hypertension (mainly preeclampsia) (p < 0.018, OR - 1.85). Conclussions: Every anatomical feature of the umbilical cord has a meaning. The abnormalities of the umbilical cord associated with undesirable outcomes are varied and should be recognized and described. Among the factors recognized as predisposing are chromosomal abnormalities, multiple gestations and as a like a new item, we found preeclampsia.