Absence of Wharton's jelly around the umbilical arteries: An unusual cause of perinatal mortality

Absence of Wharton’s jelly: case report

“…The pathogenesis has been attributed to Wharton's jelly degeneration, early incomplete fusion of amniotic and mesenchymal umbilical tissue, or hypoplasia of amnion and secondary loss of Wharton's jelly (6) . A relationship to meconium, suggested by Labarrere et al (7) but refuted by Thomlon & Hoo (10) , is probable since it was present in ours and in four out of the five previously reported cases.…”

“…The extreme reduction, commonly named the Absence of Wharton's jelly, is a very rare lesion with which the literature has presented a suggestive relationship to meconium staining, low Apgar score, and stillbirths (6,7) .…”

“…There are only six cases of absence of Wharton's jelly reported in three articles in literature: four cases were presented by Labarrere et al (1985) (7) , one case was presented by Thomlon and Hoo (1996) (10) , and one case was presented by Kulkarni et al (2007) (6) . This article describes the seventh case of the Absence of Wharton's Jelly, diagnosed by pathological examination of the placenta (Table).…”

First‐trimester sonographic umbilical cord diameter and the growth of the human embryo

“…Moreover, the presence of a lean umbilical cord in the second half of pregnancy puts the fetus at increased risk of being small-for-gestational age and of having signs of distress at delivery 5,9,10 . This seems to be the consequence of a reduced amount of Wharton's jelly 7,11 a normal constituent of the umbilical cord which plays a crucial role in maintaining the normal architecture of the umbilical cord and in regulating the blood flow from the placenta to the fetus 12 .…”

Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord

“…3,[5][6][7] Moreover, pathologic studies found an association between neonatal mortality and a macroscopic reduction in the volume of Wharton's jelly, either along the entire umbilical cord or localized in some part of it. 14,15 However, from this study and that by Raio et al, 3 it is evident that in many cases of a sonographically lean umbilical cord, the pregnancy course is uneventful and the neonatal outcome is good. Raio et al 3 reported that fewer than 1/4 of fetuses with a sonographically lean umbilical cord after 25 weeks of gestation will subsequently have growth developmental disorders or fetal distress during labor.…”