Large cross-sectional area of the umbilical cord as a predictor of fetal macrosomia

A. Cromi, F. Ghezzi, E. D I Naro, G. Siesto, V. Bergamini, L. Raio

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)861-866
Number of pages6
JournalUltrasound in Obstetrics and Gynecology
Volume30
Issue number6
DOIs
Publication statusPublished - Nov 2007

Keywords

  • Diabetes
  • Estimated fetal weight
  • Macrosomia
  • Ultrasound
  • Umbilical cord
  • Wharton's jelly

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Acoustics and Ultrasonics

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