ch. 56 Umbilical cord

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what covers cord
- amnion
- blends with fetal skin at umbilicus
vessles
- 2 arteries
- 1 vein
ub cord visualized

8 weeks til term
ub cord forms
- during first 5 weeks (7menst)
- fusion of yolk stalk and allantoic ducts
allantoic vessles

become ub vein
herniation of bowel into ub
- 7-12 weeks
- intestines grow faster than abdome
normal cord legnth/ diameter
- 40-60 cm
- 2.6-6cm
ub arteris arise from

internal illiacs along bladder
ub vein from

chorionic veins of placenta
ub arteries become
- lateral ligaments of bladder after birth
- superior vessicle arteries
no cord twists

decreased fetal movement and bad outcome
cord larger in mothers with

gest diabetes
blood from ductus venosus to

ivc and right portal to liver
short umbilical cord

under 35cm
short cord associated with
- oligohydraminos
- restricted space
- tethering by band
- fetal distress
- omphalocele
- gastroshisis
- limb wall complex
long umb cord

80 cm +
long cord associated with
- polyhydraminos
- nuchal cord
- true knots
- cord compression
- stricture or torsion from excessive movement
omphalocele
- associated with other anomolies
- membrane covering
gastrischisis
- not associated with other anomolies
- no membrane covering
- exposed to amn fluid
omphalomesenteric cyst
- cyst of umbilical cord
- females for than males
- associated with meckles diverticulum
hemangioma of cord
- rare
- near placenta end
hematoma of cord
- trauma
- blood into whartons jelly
- new- hyperechoic
- old- hypoechoic with septations
thrombus of umb vessles
- occulusion of one or more vessles
- usually vein
- higher with diabetic mothers
- second to torsion knotting compression
- poor prognosis
true knots
- long cord
- polyhydraminos
- iugr
- monoamniotic twins- 80% mortality
- single or multiple
- can happen in delivery- but no anoxia
- color to show no flow
false knots
- blood vessles are longer than the cord
- folded on themselves
nuchal cord
- most common cord entanglement
- coils around neck
- problem during delivery when head descends and cuts off oxygen
marginal insertion of cord

battledore
membranous insertion of cord

velamentous
prolapse
- when cord is below presenting part
- may be abnormal presenting fetus (trv or breech)
vasa previa
- umb cord crossing internal os of cervix
- high mortality if vag delivery
- color doppler
- velementous insertion
- succenturiate lobe
- low lying placenta
cord presentation / prolapse
- cord into vagina
- mortlaity of 25-60% when cord is compressed in vag delivery
- long cord
- premature
- myoma
- polyhydraminos
- valementous insertions
- marginal insertion in low lying placenta
- incompetent cervix
single umbilical artery
- twin pregnancy
- miscarriages
- marginal insertion more common than membranous
- atrophy of one umb artery (left more common)
- congential anomolies
- 50% born normal with single artery
aneyurism and varix
- focal dilitation of vessle
- normal outcome
persistent intrahepatic right portal vein
- paired umb veins carry blood to heart
- right umb vein regresses (6wks) and left enlarges
- sometime right persists instead of lt
- usually other anomolies too

Author

rbeacr

139523

Card Set

ch. 56 Umbilical cord

Description

umbilical cord

Updated

2012-03-04T17:57:09Z

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