Umbilical cord size and amniotic fluid volume in prolonged pregnancy

Richard K. Silver*, Sharon L. Dooley, Ralph K. Tamura, Richard Depp

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Expectant management of prolonged pregnancy is predicated on reassuring biophysical testing. However, even the combination of a reactive nonstress test and normal amniotic fluid volume may not prevent subsequent morbidity. To test the hypothesis that diminished cord Wharton's jelly incurs risk of peripartum cord compression in addition to decreased amniotic fluid, 68 patients with confirmed gestational age ≥41 weeks were evaluated prospectively with semiweekly nonstress tests and weekly ultrasound examinations. Amniotic fluid volume was assessed, and umbilical cord diameter was measured and then correlated with the quantity of Wharton's jelly at delivery, determined by cord circumference. A significant correlation between cord circumference and umbilical cord diameter was observed, even in those patients with decreased amniotic fluid volume. Either an amniotic fluid volume <3.8 cm or an umbilical cord diameter <1.6 cm was associated with significant cord compression patterns. Peripartum morbidity was greatest in the presence of a smaller cord and decreased fluid, suggesting a synergism between these two factors for the risk of cord compression in prolonged pregnancy.

Original languageEnglish (US)
Pages (from-to)716-720
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Volume157
Issue number3
DOIs
StatePublished - 1987

Keywords

  • Prolonged pregnancy
  • Wharton's jelly
  • amniotic fluid volume

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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