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OBJECTIVE: To find out the average length of umbilical cord, variation in umbilical cord length in our antenatal women and to see the the association of umbilical cord length with mode of delivery.
METHODS: This cross-sectional study was carried out at Lady Reading Hospital, Peshawar Pakistan, from Jan 2018 to Dec 2018. Using non-probability convenience sampling technique, 3300 pregnant women with singleton fetus between 37-42 weeks of gestation were included in the study. Umbilical cord length was measured by standard measuring tape. Umbilical cord length was divided into three groups and its association with mode of delivery was noted in each group.
RESULTS: Umbilical cord length in our study varied from 31-100 cm. The mean umbilical cord length was 56±9.01 cm among 3,300 participants. Short umbilical cord length (≥40 cm) was found in 62 (1.8%) cases, out of which 36 (58.06%) normal vaginal delivery (NVD) while 21 (33.87%) had Caesarean section (CS). Normal umbilical cord length (41-70 cm) was found in n=3,079 (93%) participants, out of which 2,188 (71.06%) had NVD while CS rate was 17.1% (n=526/3079). Long umbilical cord (>70 cm) was found in 159 (4.8%) cases, where 96 (60.4%) had NVD and 31 (19.5%) had CS. Nuchal cords were more common in long umbilical cord group (n=136/159; 85.53%) as compared to normal (n=371/3079; 12.04%) & short cord length (n=3/62; 4.83%).
CONCLUSION: Both long and short umbilical cords are associated with higher rate of operative vaginal delivery and caesarean section. Nchal cords were more in long umbilical cord group.
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2. Cruikshank DW, Scoott JR. Breech , other malpresentation, and umbilical cord complications. Danforth’s Obstetrics and Gynaecology 9th edition. Philadelphia, Lippincott Williams and Wikins, 2003, page 381-95
3. Carlo WA, Ambalavanan N. The umbilicus. In Klieginan RM, Nelson textbook of pediatrics 20th Edition, 2016; 890-91
4. Ranga MKSS, Mallika V. Morphplogical variations of Umbilical cord in Human Placenta. Int J Anat Res July 2019; 7(3): 786-89. DOI: 10.16965/ijar.2019.226.
5. Sharma S, Soliriya V. Study of length of umbilical cord at term and its correlation with fetal outcome: a study of 500 deliveries. J South Asian Feder Obst Gynae 2016;8(3):207-11. DOI: 10.5005/jp-journals-10006-1419.
6. Algreisi F, Brown R, Shrim A, Albasri SF, Shamarani H, AlZoubiadi A. Effect of long and short umbilical cord on perinatal outcome. Int J Reprod Contracept Obstet Gynecol 2016;5(12):4228-31. DOI: 10.18203/2320-1770.ijrcog20164042.
7. Hanaoka U, Yanagihara M, Tanaka H, Hata T. Comparision of three-dimensional, two dimensional and colour Doppler ultrasoundin predicting presence of nuchal cord at birth. Ultrasound Obstet Gynaecol 2016;19(5):471-4. DOI: 10.1046/j.1469-0705.2002.00670.x.
8. Olaya-C M, Bernal JE. Clinical association to abnormal umbilical cord length in Latin American newborns. J Neonatol Perinatal Med 2015;8(3):251-6. DOI: 10.3233/NPM-15915056.
9. Sanad ZF, Sayyed TM, Ammar HA, El-Kherbawy MF. Effects of Umbilical cord entanglement on pregnancy outcome. Monoufia Med J 2019.32;(2):448-52. DOI: 10.4103/mmj.mmj_672_17.
10. Yamamoto Y, Aoki S, Oba MS, Seiki K, Hirahara F. Relationship between Short Umbilical Cord length and adverse Pregnancy outcome. Fetal Pediatr Pathol 2016;35(2):81-7. DOI: 10.3109/15513815.2015.1122126.
11. Linde LE, Rasmussen S, Kessler J, Ebbing C. Extremes of umbilical cord lengths, cord knot and entaglement: Risk factors and risk of adverse outcomes, a population based study. PLoS One 2018;13(3):e0194814. DOI: 10.137/journal.phone.0194814.
12. Dolgun ZN, Inan C, Altintas AS, Okten SB, Karadag CS, Sayin NC. Is there A relationship between route of delivery, perinatal charateristics, and neonatal outcome in preterm birth? Niger J Clin Pract 2018;21(3):312-17. DOI: 10.4103/njcp.njcp_333_16.
13. Krakowiak P, Smith EN, de Bruyn G, Lydon-Rochelle MT. Risk factors and out comes with a short umbilical cord. Obstet Gynecol 2004;103(1):119-27.
14. Nandini B, Deepali J, BalGopal B, Shaheen A, Jyothi D. Relationship between umbilical cord length and maternal and fetal outcome. Ind J Res July 2015;4(7):114-7.
15. LaMonica GE, Wilson ML, Fullilove AM, Rayburn WE. Minimum cord length that allows spontaneous vaginal delivery. J Reprod Med 2008 March;55(3):217-9.
16. Shiva Kumar HC,Tharihalli CT, Chandrashekhar K, Gaddi SF. Study of umbilical cord and fetal outcome: a study of 1000 deliveries. Int J Reprod Contracept Obstet Gynecol 2017 Sep; 6(9):3770-5. DOI: 10.18203/2320-177.ijrcog20173622.
17. Yadav BB, Kurdukar DV, Darade RV, Mahadar NA. Correlation of umbilical cord length with fetal and maternal outcome. J Evol Med and Dent Sci 2013 Jan 28;(2):412-17.
18. Joshi K, Saxena R, Bhat M, Lomord Y, Verma K. Incidence of cord around the neck and its effects on labour and neonatal outcome. Adv Human Biol 2017 Jan;7(1):15-8. DOI: 10.4103/2321-8568.199535.
19. Khadim EJ, Ali YNM, Sher SS, Fawzi HA. The Length of Umbilical cord and perinatal outcome. Ind J Public Health Res Dev 2019;10(5):576-80. DOI: 10.5958/0976-5506.2019.01068.4.
20. Soliriya V, Goyal M, Kachhawaha CP. Perinatal mortality and umbilical cord parameters. Is there any association? J Preg Child Health Jul 2017;4(4):10-3. DOI: 10.4172/2376-127X.1000340.