Altered Sonographic Umbilical Cord Morphometry in Early-Onset Preeclampsia

Abstract

In Brief OBJECTIVE To determine whether the sonographic morphometry of the umbilical cord components is different in preeclamptic compared with healthy pregnant women. METHODS Consecutive women admitted after 20 weeks' gestation with the diagnosis of preeclampsia and whose fetus was normally grown (cases) were included in the study. Each case was matched to a healthy pregnant woman (controls) who had ultrasonography at the same gestational age (± 3 days). The sonographic cross-sectional areas of the umbilical cord and umbilical vessels were obtained in all patients and plotted on reference ranges. The umbilical artery resistance index was measured in all patients with preeclampsia. RESULTS Twenty-five preeclamptic women were enrolled. The proportion of cases with a lean (below the tenth centile) umbilical cord was higher in cases than in controls (12 of 25 versus 1 of 25, P < .001). The Wharton's jelly area was lower in cases than in controls (median 105.8 mm2 [range 49.6–212.9 mm2] versus 138.7 mm2 [79.7–226.6 mm2], P = .024). The umbilical vein area was less in cases than in controls (median 29.2 mm2 [range 8.0–52.8 mm2] versus 37.4 mm2 [13.8–70.8 mm2], P = .032). The proportion of patients with a lean umbilical cord was higher among those with early-onset preeclampsia than in those with late-onset preeclampsia (12 of 19 versus 0 of 6, P = .014). CONCLUSION Early-onset preeclampsia frequently is associated with reduced Wharton's jelly area and umbilical vein area compared with normal pregnancy. Sonographic umbilical cord morphometry might have clinical value for prompt identification of women at risk for preeclampsia. The umbilical cords of women with early-onset preeclampsia are more likely to be lean and to have a smaller umbilical vein size than those of women with an uneventful pregnancy course.