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ABSENT
WHARTON’S JELLY (THIN CORD) |
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NORMAL
WHARTON’S JELLY |
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ABSENCE OF
WHARTON’S JELLY |
Total or focal absence of Wharton's jelly has been rarely reported. Macroscopically the lesion may resemble velamentous insertion, but the vessels are bare and not covered by membranes (1).
Wharton's jelly consists of mucopolysaccharides (especially hyaluronic acid and chondroitin sulphate). Occasionally small cysts appear in the jelly however rarely degenerative changes may denude the vessels. The jelly acts as a supportive structure and protects the vessels of the umbilical cord against compression and constriction.
- Labarrere and co-workers (2) report three cases (one died antenatally and the other two shortly after birth).
- Bergman and co-workers (3) report two cases (one child was born dead).
- There are numerous reports in the literature of localized constriction of the umbilical cord (with / without tension) but deficient of Wharton's jelly in the affected area (1).
- A reduction in Wharton's jelly is frequently present in cases of single umbilical artery (4). The authors suggest that the increased perinatal morbidity and mortality associated with SUA, even in the absence of other congenital anomalies may in part be due to a reduced amount of Wharton's jelly.
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Straight
cord Absent
Whartons Jelly |
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REFERENCES |
- Clausen I. Umbilical cord anomalies and antenatal fetal death. Obstetrical and Gynecological Survey 1989;44(12):841-845.
- Labarrere C, Sebastiani M, Siminovich M et.al. Absence of Wharton's jelly around the umbilical arteries: An unusual cause of perinatal mortality. Placenta 1985;6:555.
- Bergman P, Lundin P, Malmstrom T. Mucoid degeneration of Wharton's jelly. Acta Obstet Gynecol Scand 1961;40:372.
- Ghezzi RL, Di Naro F, Balestreri D et.al. Amount of Wharton's jelly in the umbilical cord with single artery. World Congress on Ultrasound in Obstetrics and Gynecology. Poster Presentation. Edinburugh, Nov/Dec 1998.
- Raio L, Ghezzi F, Di Naro E et.al. Prenatal assessment of Whartons jelly in umbilical cords with a single artery. Ultrasound Obstet Gynecol 199;14:42-46.