Umbilical cord length and cord abnormalities in term singleton pregnancy: A Review of pregnancy outcome in a tertiary health institution in Nigeria

Objective: To determine the association of feto-maternal  outcomes  of term pregnancies with  fetal umbilical cord lengths and cord abnormalities in Calabar. Methods:  A cross-sectional study of 600 women with singleton pregnancies who delivered either virginally or caesarean section between 37 and 42 completed weeks. Examination of cord was done at delivery for loop round neck, cord length, knots and cord abnormalities. Outcomes recorded include foetal presentation, sex,  birth weight, length of newborn and Apgar scores at 1st and 5th minutes. Also, mode of delivery, labour duration and maternal complications were noted.  Cords with abnormalities were sent for histological examination. Data was analyzed using SPSS version 20. Level of significance was set at p-value < 0.05. Results:  The mean cord length was 61.07 ± 14.931cm, short  cords were 23(7.7%), long cords were 37 (12.3%) and 480 (80.0%) were normal length.  Male foetuses had longer cords,   mean cord length in the vertex presentations were significantly longer than in breech presentation and increased with increase in birth weight.  Abruptio placenta was higher among foetuses with short umbilical cord.  (17.4% vs 0.4%) (p-value-0.000).   There was positive correlation between foetal weight and umbilical cord length. Cord coiling index showed a negative correlation with cord length (r = -0.261; p-value = 0.000). Conclusion: Abnormal umbilical cord lengths significantly predispose to obstetric complications but cord abnormalities are rare and does not affect pregnancy outcome.  High index of suspicion and careful evaluation of cord may inform and reduce untoward feto-maternal outcome