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Anatomy scan image of a human placenta and umbilical cord (colour Doppler rendering) showing central placement of the cord in the placenta and three vessels in the cord, which is the normal physiology. A standard anatomy scan typically includes: [4] Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations
The embryo is surrounded by the thin membranes of the amniotic sac, the umbilical cord is seen in the center, attaching the embryo to the placenta. The umbilical cord develops from and contains remnants of the yolk sac and allantois. It forms by the fifth week of development, replacing the yolk sac as the source of nutrients for the embryo. [2]
A nuchal cord is when the umbilical cord becomes wrapped around the fetus's neck. [1] Symptoms present in the baby shortly after birth from a prior nuchal cord may include duskiness of face, facial petechia, and bleeding in the whites of the eye. [1] Complications can include meconium, respiratory distress, anemia, and stillbirth. [1]
Occasionally, during pregnancy, there is a single umbilical artery (SUA) present in the umbilical cord, as opposed to the usual two. [1] This is sometimes also called a two-vessel umbilical cord, or two-vessel cord. Approximately, this affects between 1 in 100 and 1 in 500 pregnancies, making it the most common umbilical abnormality.
Umbilical cord prolapse is when the umbilical cord comes out of the uterus with or before the presenting part of the baby. [2] The concern with cord prolapse is that pressure on the cord from the baby will compromise blood flow to the baby. [2] It usually occurs during labor but can occur anytime after the rupture of membranes. [1] [5]
Percutaneous umbilical cord blood sampling (PUBS), also called cordocentesis, fetal blood sampling, or umbilical vein sampling is a diagnostic genetic test that examines blood from the fetal umbilical cord to detect fetal abnormalities. [1] Fetal and maternal blood supply are typically connected in utero with one vein and two arteries to the fetus.
In velamentous cord insertion, the vessels of the umbilical cord are improperly inserted in the chorioamniotic membrane, and hence the vessels traverse between the amnion and the chorion towards the placenta. [1] [11] Without Wharton's jelly protecting the vessels, the exposed vessels are susceptible to compression and rupture. [1] [9]
The use of fetal scalp blood testing originated in Germany in 1961 and required 0.25 mL of blood drawn from the fetus. [1] As one of the first methods of monitoring fetal wellbeing during labor, there were many disadvantages including the need for at least 3 cm dilation of the mother and extreme precision from the physician performing the procedure. [9]