Abstract
Objectives: 1) To determine the incidence of cord entanglement during early gestation using three dimensional (3D US) sonography. 2) To establish relationship between fetal and umbilical cord lengths, as a suggested pathophysiology for the cord entanglement incidence throughout pregnancy. Material and Methods: A prospective consecutive study was designed and 3D US was performed. Two hundred and thirty seven singleton pregnancies between 13–16 weeks were included. Cord entanglement was defined when one or more of the following was detected: cord around neck, hand, leg, thorax, abdomen shoulder, pelvis. Floating free cord through all its length in the amniotic fluid was defined as normal position cord. Results: Abnormal cord position was observed in 149 (62.9%) patients. Of those: 42.9.0% around neck, 15.4% legs, 12.7% hands, 4.8% -abdomen, 24.2% -other body parts (thorax, shoulder and pelvis). Incidence of total cord entanglement was similar between 13–16 weeks gestation. A decreasing ratio between cord length and CRL (according to literature) was calculated throughout pregnancy. Conclusions: A high incidence of early second trimester cord entanglement was found. This may be explained by the high calculated ratio between cord and fetal lengths during early pregnancy. Cord entanglement should be considered a part of normal early fetal movements and development.
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