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


        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


o        Amniotic inclusion cysts.

o        Omphalomesenteric cyst.

o        Vesicoallantoic cyst.

o        Allantoic cyst.

o        Pseudocyst.