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Object: To determine the chiral varieties of the vascular helix of the umbilical cord and find their normal proportions., Design: Differences between the sexes were tested by a chi 2 test and the hypothesis that left-handed types occur in 50% of cases was tested using the binomial distribution., Setting: United Arab Emirates., Subject: Gulf Arab singletons from consecutive normal births, 100 male and 100 female., Results: Left-handed helices predominate at 76.5%; right-handed contribute 15.5%; mixed forms, where both chiralities co-exist, were found in 6.5%; indeterminable chirality due to poor helix formation, or varices, reached 1.5%. A significant sex difference could not be established. Chiral generation, on genetic and mechanical-rotational hypotheses, is discussed., Conclusion: The chirality of the cord is easily determined and is the sole distinguishing feature of the cord. Chirality should be entered in the birth record and in pathological descriptions for whatever value it may have in relation to fetal, or postnatal, characteristics and morbidity.

A prospective longitudinal investigation of spontaneous cephalic version from breech presentation in the last trimester is reported. All pregnancies were assessed with ultrasound in the 32nd week of gestation, and were thereafter checked weekly. Of the 310 singleton breech presentations identified at 32 weeks, spontaneous cephalic version occurred in 177 (57%) while breech presentation persisted in 133 patients (43%). Of 140 patients with a breech presentation at delivery 95% were already presenting by the breech in the 32nd week. Spontaneous cephalic version was less likely in pregnancies with extended fetal legs, low birth-weight, short umbilical cord and primiparity.

The site of the insertion of the umbilical cord into the placenta was determined in 940 consecutive term infants. No relation was found between birth weight and whether the cord was inserted centrally, eccentrically or marginally.

The claims that marginal and velamentous insertion of the cord are associated with a high incidence of abortion, low birth weight, premature delivery, fetal malformation, fetal hypoxia and intrauterine fetal death have been investigated. A study of 1000 cases has failed to demonstrate any such association.

In 429 placentae, measurements were made of weight, diameter, shape, eccentricity of the cord and weight and length of the cord, and the results were compared with Apgar score of the infant at birth and its standardized birth weight. There was no evidence that cord eccentricity, placental shape or "thickness", or the dimensions of the cord had any significant relation to the growth of the fetus or its condition at birth. The value of routine recording of crude measurements and qualitative assessments of the placenta in case notes is questioned.