Abstract
To verify the association between the macroscopic characteristics of the umbilical cord, high-risk pregnancy and neonatal repercussions. A cross-sectional study carried out from January 2012 to January 2015 in a public maternity hospital in Goiânia/GO. The study population consisted of 126 recent puerperal women with diagnosis of high-risk pregnancy, and 139 clinically normal women (control group). Macroscopic features of the umbilical cord, maternal, fetal and neonatal diseases, gestational age, Apgar score, birth weight, head circumference and parity were evaluated. Data were descriptively analyzed. 265 puerperal women and their respective newborns participated in the study. The most frequent characteristics of the umbilical cord of those with high-risk pregnancy and those from the control group were the absence of true knots (97.6% and 2.4%, respectively), length between 35 and 70 centimeters and paracentral insertion (81.7% and 18.3%). A statistical difference was observed between the high-risk pregnancy group and extremes of maternal age (p=0.004). The analysis and description of the characteristics of the umbilical cord carried out by the nurse lend important information about the neonatal prognosis. This evaluation subsidizes clinical practice and seeks to ensure the safety of the (mother-baby) binomial throughout the perinatal period.
Highlights
In the gestational process, the line between normality and disease is extremely thin and the imbalance represents a high risk of maternal-fetal morbidity and mortality[1,2]
Among the macroscopic characteristics evaluated in the umbilical cord, the most frequent was length between 36 and 70 cm in women with gestational diabetes mellitus (GDM) (50%) and gestational hypertension (GH) (53%), and paracentral insertion in the GDM (87%) and GH groups (76.5%) (Table 1)
The obstetric characteristic that most stood out was maternal age higher or equal to years of age in the high-risk pregnancy group when compared to the control group (p=0.004), and gestational age less than weeks in both high-risk pregnancy and control groups (Table 2)
Summary
The line between normality and disease is extremely thin and the imbalance represents a high risk of maternal-fetal morbidity and mortality[1,2]. There is a close relationship between placenta/umbilical cord, fetus and the change in its functions, as in the cases of GH and GDM This relationship establishes different patterns of pregnancy outcomes and the evolution of fetal and/or maternal injury[3]. The umbilical cord is an essential structure for maintenance of intrauterine life, and it can be used for assessing adverse perinatal conditions, contributing to a good neonatal prognosis[7]. This evaluation is performed through the macroscopic identification of umbilical cord alterations, and could, for example, elucidate causes of perinatal hypoxia which are not evidenced in the clinic, providing a better understanding of the physiopathogenesis of fetal events
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