1. Large cross-sectional area of the umbilical cord as a predictor of fetal macrosomia.
- Author
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Cromi A, Ghezzi F, Di Naro E, Siesto G, Bergamini V, and Raio L
- Subjects
- Adult, Amniotic Fluid diagnostic imaging, Cross-Sectional Studies, Diabetes, Gestational, Female, Gestational Age, Humans, Infant, Newborn, Male, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Pregnancy in Diabetics, Ultrasonography, Umbilical Cord pathology, Fetal Macrosomia diagnostic imaging, Pregnancy, High-Risk, Umbilical Cord diagnostic imaging
- Abstract
Objective: To determine whether a large cross-sectional area of the umbilical cord is a predictor of fetal macrosomia., Methods: Consecutive patients of > 34 weeks' gestation, who presented for sonographic examination and who delivered within 4 weeks of the examination, were included in the study. The sonographic cross-sectional areas of the umbilical cord, the umbilical vessels and the Wharton's jelly were measured in a free loop of the umbilical cord. Logistic regression analysis was used to determine significant predictors of macrosomia (actual birth weight > 4000 g and > 4500 g). Fetal biometric parameters (biparietal diameter, abdominal circumference and femur length), sonographic estimated fetal weight and umbilical cord area > 95(th) centile for gestational age were used as covariates., Results: During the study period, 1026 patients were enrolled. Fifty-three (5.2%) newborns had a birth weight > 4000 g, and 22 (2.1%) weighed > 4500 g. The proportion of cases with a large umbilical cord was significantly higher in the group of macrosomic compared with non-macrosomic infants (54.7% vs. 8.7%, P < 0.0001). Multiple regression models demonstrated an independent contribution of the large cord in the prediction of birth weight > 4000 g and > 4500 g (odds ratio (95% CI), 20.6 (9.2-45.9) and 4.2 (1.2-17.7), respectively). The sensitivity, specificity and positive and negative predictive values of a sonographic large umbilical cord were 54.7%, 91.3%, 25.4%, and 97.4%, respectively. The combination of abdominal circumference > 95(th) centile and large cord predicted 100% of macrosomic infants. The proportion of umbilical cords with a Wharton's jelly area > 95(th) centile for gestation was significantly higher in macrosomic fetuses of diabetic compared with non-diabetic mothers., Conclusions: Sonographic assessment of umbilical cord area may improve the prediction of fetal macrosomia.
- Published
- 2007
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