Ultrasound evaluation of the size of the umbilical cord vessels and Wharton’s jelly and correlation with intrapartum CTG findings

•A reduced amount of the Wharton's Jelly (WJ) has been found to predict the occurrence of repetitive decelerations.•The WJ area is the only factor significantly and negatively associated with the total deceleration area in the 1st stage of labor.•In those cases with a reduced amount of WJ, a ta...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2025-02, Vol.305, p.42-47
Main Authors: di Pasquo, Elvira, Dall’Asta, Andrea, Volpe, Nicola, Corno, Enrico, Di Ilio, Chiara, Bettinelli, Maria Laura, Ghi, Tullio
Format: Article
Language:English
Subjects:
Cardiotocography
Deceleration
Intrapartum monitoring
Umbilical cord
Wharton’s Jelly
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Summary:•A reduced amount of the Wharton's Jelly (WJ) has been found to predict the occurrence of repetitive decelerations.•The WJ area is the only factor significantly and negatively associated with the total deceleration area in the 1st stage of labor.•In those cases with a reduced amount of WJ, a tailored labor management may be considered to lower the risk of fetal distress. To compare the sonographic measurement of the umbilical cord between women with or without repetitive decelerations during the first stage of labor. Prospective study including a non-consecutive cohort of women at term gestation carrying a normal sized fetus at term in cephalic presentation. The cross-sectional area of the umbilical cord, of its vessels and the amount of the Wharton’s jelly were assessed at 2D ultrasound upon labor admission. The CTG traces recorded in labor were retrospectively evaluated and the biometric parameters of the umbilical cord were compared between women with or without repetitive decelerations during the first stage and their correlation with the total deceleration area/total length (stage I TDA/t) of the first stage of labor (overall and following the rupture of membrane) was assessed. Overall, 113 women were included, of whom 21 (18.6 %) presented repetitive decelerations during the first stage of labor. In this latter group, the umbilical cord showed a significantly smaller total arterial area (24.4 ± 10.7 vs. 19.6 ± 9.0 mm2; p = 0.02), vein area (46.8 ± 13.6 vs. 34.1 ± 13.3 mm2; p 
ISSN:0301-2115
1872-7654
1872-7654
DOI:10.1016/j.ejogrb.2024.11.048