Abnormalities of the Umbilical Cord

 

Normal anatomy of the umbilical cord

Embryology of the umbilical cord.

Abnormalities of cord length.

Abnormalities of the cord vessels.

·        Single umbilical artery.

·        Hypoplastic umbilical artery

·        Umbilical vein

·        Varix.

·        Persistent right umbilical vein

·        Agenesis of the ductus venosus (with aberrant insertion of umbilical vein)

·        Umbilical artery/vein thrombosis

·        Accessory vessels (4 + 5 vessel cord)

·        AVM / aneurysm / stricture.

·        Umbilical cord hematoma.

·        Rupture of umbilical cord vessels

Abnormalities of cord coiling.

Abnormalities of cord position.

·        Nuchal cord.

·        Cord compression.

·        Cord presentation and prolapse.

·        Entangled umbilical cord (in twin pregnancies).

·        Vasa previa.

 

Abnormalities of supporting tissue:

·        Normal cord matrix.

·        Thick cord.

·        Thin cord (absent Wharton’s jelly).

Umbilical cord knots.

·        False knot.

·        True knot.

 

Abnormalities of cord insertion.

·        Fetal site.

o       Umbilical Cord Hernia.

o       Omphalocele / Gastroschisis

o       Patent Urachus / MURCS Association.

 

·        Placental site.

o        Velamentous cord insertion.

o        Marginal cord insertion (“Battledore placenta”).

Doppler of the umbilical cord.

·        Principles of doppler.

·        Twin pregnancies/ TRAP sequence (acardiac twin).

·        Normal waveform in the umbilical vein.

·        Abnormal waveforms in the umbilical vein.

·        Normal waveform in the umbilical artery.

·        Abnormal waveform in the umbilical artery

Umbilical cord masses.

·        Neoplasms – Hemangioma /Teratoma / Angiomyxoma

·        Cysts.

o        Amniotic inclusion cysts.

o        Omphalomesenteric cyst.

o        Vesicoallantoic cyst.

o        Allantoic cyst.

o        Pseudocyst.