The Umbilical Cord

The umbilical cord connects the fetus with the placenta, allowing fetal blood to travel to and from the placenta. It spreads from the fetal umbilicus to the placental surface. The connecting stalk gives rise to the umbilical cord. It is typically 35—50 cm long and 1.5–2cm in diameter. It has two umbilical arteries that continue the hypogastric arteries and one umbilical vein. From left to right, the vessels are spirally twisted. Amnion unsheathes the cord. Wharton's jelly is a mucoid connective tissue that makes up the cord.

Abnormalities of cord

Variation in the insertion of the umbilical cord

• Battledore insertion: The umbilical cord is usually placed at or near the middle of the placenta. It is referred to as marginal or battledore insertion if it is implanted at the placental margin. It may predispose to cord presentation or cord prolapse, and cord compression during vaginal birth may result in fetal anoxia or even death
• Velamentous insertion of the cord: A Velamentous cord insertion occurs when the umbilical cord blood vessels that connect the newborn to the placenta take an unusual path—they left the baby's body normally, but as they return to the placenta, they exit the cord and enter the membranes. As a result, the cord insertion location becomes the amniotic membrane rather than the placenta. Because the vessels are no longer cushioned by the cord, they are subject to ripping.

Abnormal Length

• Short length: The short cord could be correct.

• Long length: Because of the presence of a long chord, there is an increased risk of cord prolapse, cord entanglement around the neck or body, genuine knot, and false knot.

Single Umbilical Artery

The umbilical cord is expected to have two arteries and one vein, however, is roughly 1% of pregnancies (and in 3% of multiples pregnancies), and the chord only has one artery. The arteries are incredibly narrow vessels that bring blood from the fetus back to the placenta. The vein transports blood from the mother to the infant, and the umbilical cord vein is one of the largest blood vessels in the human body.

This condition's source is unknown, however, it can be discovered with a regular ultrasound procedure. Some studies have suggested that a single umbilical artery puts the fetus at risk for certain birth defects, such as central nervous system, urinary tract, and heart abnormalities; however, only one cord artery is required for the fetus to live, and the baby is usually born without any other abnormalities.

Cord Stricture

Cord stricture is the construction or occlusion of the cord. The causes are unknown, however, it could result from a lack of Wharton jelly in the umbilical cord in the area of s, which could lead to post-morbid alterations.

Nuchal Cord

A wrapped umbilical cord around the infant's neck. This may sound ominous, but most kids born this way are healthy, and the births are usually uneventful. Fetal monitoring may reveal occasional fetal heartbeat alterations during labor, indicating that there is intermittent aberrant pressure on the umbilical cord, although this pressure is rarely severe enough to cause serious complications, a C-section delivery may be required in certain cases. At every vaginal birth, the birth attendant makes a brief examination of the neck area to "check for a chord" as soon as the baby's head emerges. If the cord is present, it is frequently gently pulled over the head, a procedure known as "reducing" the cord.

References

• Embryology. 27 01 2017. 07 03 2017 <https://embryology.med.unsw.edu.au/embryology/index.php/Placenta_-_Abnormalities>.
• Nursing Crib. 11 November 2010. <http://nursingcrib.com/nursing-notes-reviewer/maternal-child-health/anomalies-of-the-placenta/>.
• Access Medicine. <http://accessmedicine.mhmedical.com/content.aspx?bookid=350&sectionid=41680591&jumpsectionID=41685878>.
• Sweet, B.r., 1989, Maye's midwifery, A textbook for midwives; 11th edition, Bailliere Tindall, London, Philadelphia
• Tuitui R. 2002, A textbook of Midwifery A (Antenatal), 3rd edition, Vidyarthi Pustak Bhandari (Publisher and Distributor), Bhotahity, Kathmandu