Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology
Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean deli...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/2/236 |
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| author | Roxana Elena Bohîlțea Vlad Dima Ioniță Ducu Ana Maria Iordache Bianca Margareta Mihai Octavian Munteanu Corina Grigoriu Alina Veduță Dimitrie Pelinescu-Onciul Radu Vlădăreanu |
| author_facet | Roxana Elena Bohîlțea Vlad Dima Ioniță Ducu Ana Maria Iordache Bianca Margareta Mihai Octavian Munteanu Corina Grigoriu Alina Veduță Dimitrie Pelinescu-Onciul Radu Vlădăreanu |
| author_sort | Roxana Elena Bohîlțea |
| collection | DOAJ |
| description | Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies. |
| first_indexed | 2024-03-09T22:13:36Z |
| format | Article |
| id | doaj.art-aa87fd007e3a4592bbaff9cdeaacdf5c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T22:13:36Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-aa87fd007e3a4592bbaff9cdeaacdf5c2023-11-23T19:28:37ZengMDPI AGDiagnostics2075-44182022-01-0112223610.3390/diagnostics12020236Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord PathologyRoxana Elena Bohîlțea0Vlad Dima1Ioniță Ducu2Ana Maria Iordache3Bianca Margareta Mihai4Octavian Munteanu5Corina Grigoriu6Alina Veduță7Dimitrie Pelinescu-Onciul8Radu Vlădăreanu9Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, RomaniaDepartment of Obstetrics, Gynecology and Neonatology, Filantropia Hospital, 11–13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, University Emergency Hospital, 169 Splaiul Independentei Bld., Sector 5, 050098 Bucharest, RomaniaOptospintronics Department, National Institute for Research and Development in Optoelectronics-INOE 2000, 409 Atomistilor, 077125 Magurele, RomaniaDepartment of Obstetrics, Gynecology and Neonatology, Filantropia Hospital, 11–13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, RomaniaDepartment of Anatomy, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, RomaniaDepartment of Obstetrics, Gynecology and Neonatology, Filantropia Hospital, 11–13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, RomaniaUmbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies.https://www.mdpi.com/2075-4418/12/2/236umbilical cordprenatal diagnosisultrasound3D imagingcolor Dopplervasa praevia |
| spellingShingle | Roxana Elena Bohîlțea Vlad Dima Ioniță Ducu Ana Maria Iordache Bianca Margareta Mihai Octavian Munteanu Corina Grigoriu Alina Veduță Dimitrie Pelinescu-Onciul Radu Vlădăreanu Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology Diagnostics umbilical cord prenatal diagnosis ultrasound 3D imaging color Doppler vasa praevia |
| title | Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology |
| title_full | Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology |
| title_fullStr | Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology |
| title_full_unstemmed | Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology |
| title_short | Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology |
| title_sort | clinically relevant prenatal ultrasound diagnosis of umbilical cord pathology |
| topic | umbilical cord prenatal diagnosis ultrasound 3D imaging color Doppler vasa praevia |
| url | https://www.mdpi.com/2075-4418/12/2/236 |
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