Anatomical pathology of the umbical cord in cases of fetal congenital heart disease

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Objective: The purpose of the study was to determine the pathological features of the umbilical cord structure associated with live born small for gestational age and premature baby with prenatally diagnosed congenital heart disease (CHD).

Materials and methods: A retrospective analysis of the results of macroscopic examination of the umbilical cords was carried out in antenatally formed in the cohort with 115 cases of fetal CHD. A group of cases was divided into subgroups depending on the gestational age at delivery and baby weight at birth. Subroup 1 included 15 cases with premature and/or SGA infants; subgroup 2 consisted of 100 full-term infants with birth weight ≥ 10th percentile.

Results: Short (58.2% of cases) and lean (43.4% of cases) umbilical cord, abnormal attachment to the placenta (35.6% of cases), hypo-and hypercoiled cord (4.3% and 19.1% of cases) were most commonly observed, respectively. Pathological variants and their combinations in one umbilical cord were found in 74% and 34% of cases.

There were differences between the subgroups in the frequency of occurrence of hypercoiled and lean umbilical cord, and combined pathology, that was 46.6% versus 15%, 73.3% versus 39%, 60% versus 30% in subgroups 1 and 2, respectively, (р<0,05). At the same time, the odds ratio for the birth of premature and/or small for gestational age baby with CHD was 4.96 (95% CI 1.56–15.7), 4.3 (95% CI 1.28–14.45) and 3.5 (95% CI 1.14–10.8), respectively.

Conclusion: Postnatal assessment showed that umbilical cord pathology was in 74% of cases in babies born with congenital heart disease. Hypercoiled, lean umbilical cord and combination of umbilical cord abnormalities were significantly associated with preterm births and small for gestational age newborns. The obtained results indicate the need to expand the protocol for ultrasound assessment of the umbilical cord in cases of fetal cardiac pathology.

Sobre autores

Tamara Yarygina

A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia; Academician V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology; Patrice Lumumba Peoples' Friendship University of Russia

Autor responsável pela correspondência
Email: tamarayarygina@gmail.com
ORCID ID: 0000-0001-6140-1930

Researcher at the Perinatal Cardiology Center; PhD, Head of the Ultrasound Diagnostics Department; Associated Professor at the Department of Ultrasound Diagnostics of the Faculty of Continuing Medical Education of the Medical Institute

Rússia, Moscow; Moscow; Moscow

Rena Gasanova

A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia; Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: rmgasanova@bakulev.ru
ORCID ID: 0000-0003-3318-1074

Dr. Med. Sci., Head of the Perinatal Cardiology Center; Physician of Ultrasound Diagnostics, Department of Ultrasound and Functional Diagnostics

Rússia, Moscow; Moscow

Olga Marzoeva

A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia

Email: ovmarzoeva@bakulev.ru
ORCID ID: 0000-0003-4475-0105

PhD, Doctor of Ultrasound Diagnostics, Researcher at the Perinatal Cardiology Center

Rússia, Moscow

Elena Sypchenko

A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia

Email: evsypchenko@bakulev.ru
ORCID ID: 0000-0002-8809-7913

PhD, Doctor of Ultrasound Diagnostics at Perinatal Cardiology Center

Rússia, Moscow

Elena Leonova

A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia

Email: eileonova@bakulev.ru
ORCID ID: 0000-0002-6140-7950

Doctor of Ultrasound Diagnostics at Perinatal Cardiology Center

Rússia, Moscow

Vyacheslav Lyapin

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_lyapin@oparina4.ru

Pathologist of the Pathology Department

Rússia, Moscow

Alexander Shchegolev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: ashegolev@oparina4.ru
ORCID ID: 0000-0002-2111-1530

Dr. Med. Sci., Professor, Head of the 2nd Pathoanatomical Department

Rússia, Moscow

Alexander Gus

Patrice Lumumba Peoples' Friendship University of Russia; Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_gus@oparina4.ru
ORCID ID: 0000-0003-1377-3128

Dr. Med. Sci., Professor, Chief Researcher at the Department of Ultrasound and Functional Diagnostics; Head of the Department of Ultrasound Diagnostics of the Faculty of Continuing Medical Education of the Medical Institute

Rússia, Moscow; Moscow

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