Umbilical Venous Pulsation Associated with Hypercoiled Cord in Growth-Retarded Fetuses

Abstract

Venous pulsatile flows were detected by pulsed Doppler flow velocimetry throughout the entire umbilical cord in 2 cases of intrauterine growth retardation. Although the hearts of these fetuses had no anomalies and their inferior vena cava flows had normal flow velocity patterns, their cords were severely coiled. In these cases, the pulsatile flow in the umbilical cord vein was caused not by an increase in the preload of the fetal heart, but only by hypercoiling of the umbilical cord. This phenomenon also suggests that the coiled umbilical cord exerts a pump-like effect known as a ‘pulsometer’.

Ultrasound Evaluation of the Amount of Wharton’s Jelly and the Umbilical Coiling Index

“…Furthermore, HCC is associated with a pulsate pattern of the umbilical venous flow velocity waveforms similar to those seen in abnormalities of the fetal central venous flow, secondary to severe circulatory compromise [14,15] . These findings suggest that HCCs may result in compression of the umbilical vein and compromise of the placentofetal blood flow.…”

The effect of vascular constriction on umbilical venous pulsation

“…than in the cord (43/198,22%,30%, (P < 0.001). When pulsation was observed intra-abdominally, the pulsatility was not different from that at the umbilical ring (P = 0.16).…”

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ABSTRACT

Objectives

Results The incidence of umbilical venous pulsation was higher at the umbilical ring in the abdominal wall (242/279, 87%, than in the cord (43/198,22%,30%, (P < 0.001). When pulsation was observed intra-abdominally, the pulsatility was not different from that at the umbilical ring (P = 0.16).

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Accurate diagnosis of umbilical circulation

“…Umbilical venous pulsations were observed only at several regions of the umbilical cord in normal fetuses [54], in spite of what was observed over the entire umbilical cord in intra-uterine growth restriction with a hypercoiled umbilical cord [50,51]. These regional umbilical pulsations occurred at points where the umbilical cord winded at large angles (especially more than 60 degrees) or where the umbilical cord was compressed [55].…”