Sonographic umbilical cord morphology and perinatal outcome in fetuses with preclampsia and intrauterine growth restriction in second and third trimester

Accurate estimation of fetal well-being during pregnancy can provide useful information to assess the health of the fetüs and newborn to the clinician. There have been many studies about the relation between fetal biometry and estimated fetal weight (EFW) with the thickness of umbilical cord (UC), UC area and Wharton Jelly (WJ). To date UC assesment has not been a part of the routine practice due to various factors. This study has been performed in patients with preeclampsia and intrauterine growth restriction (IUGR) comparing to controls to investigate the UC parameters including UC area, umbilical vein (UV) area, WJ, umbilikal artery (UA) area as markers for fetal well being. The rates of cord parameters (UC/UV, UC/UA and UV/UA) were calculated to decrease the interobserver variability and to stardardize among gestational age.Eighty-nine patients between 26-41 weeks were included. 40 patients diagnosed as preeclampsia and/or IUGR were compared to control subjects (n=49). UC parameters, UA Doppler parameters, fetal biometry and EFW were measured in all cases.UC and WJ areas were statistically significantly lower in the group with preeclampsia and/or IUGR than the control group (p<0.05). For the rate of UC parameters, there was no statistically significant difference between two groups (p>0.05). There was a statistically significant negative correlation for UA RI, UC area, WJ area, UV area and UV/UA rate in two groups (UA RI and UC area: r= -0.37, UA RI and WJ area: r= -0.38, UA RI and UV area: r= -0.28, UA RI and UV/UA area: r= -0.28, p<0.05).As a conclusion, sonagraphic assesment of UC parameters can be valuable in evaluating patients with preeclampsia and/or IUGR for the status of fetüs. The rates of UC parameters do not seem to be effective in the evaluation of the abnormal pregnancies. However prospective studies are needed to reach a definite conclusion about the role of UC sonography in fetuses with preeclampsia and IUGR.