Umbilical cord anomalies in high-risk pregnancy and its association with the perinatal outcome: A cross-sectional study

Abstract

Background and objective: There are no local investigation on the role of the abnormal umbilical cord on neonatal and maternal outcomes in this region. This study aimed to examine the association of umbilical cord abnormalities on neonatal and maternal outcomes in Iraqi Kurdistan. Methods: This is a cross-sectional study, the patients who attended the Duhok Obstetrics and Gynecology Teaching Hospital in Duhok city were examined between 1/11/2020 and 1/11/2021. The sample size is 500 women, inclusion criteria are age>18 years, acceptance to participate, gestational age >24 weeks and singleton pregnancy. The exclusion criteria are women who refused to participate, multiple pregnancy and stillbirth. Results: The mean age of the pregnant women was 29.0 (16 - 45 years old). The most prevalent maternal complications were placenta Previa (7.06%), Polyhydramnios (9.88%), and post-partum hemorrhage (7.06%). In this study the most common abnormalities of UC were abnormal diameter of UC (29.4%), decreased Wharton jelly content (15.5%) and short UC (11.9%).Most of the patients’ babies had normal weight (79.64%), (16.94%) had low birth weight and (3.43%) had very low birth weight. A percentage of the babies died either early neonatal (1.41%) or stillbirth (5.24%). The study found that the patients with abnormal diameter of UC cord were more likely to have babies with low birth weight (35.62% vs. 9.14%, P <0.0001) and were more likely to suffer from stillbirth (9.59% vs. 3.43%). Patients with short UC were more prone to have abruptio placenta (20.34% vs. 2.75%) and PROM (13.56% vs. 3.66%) ,and neonates with short UC were more likely to be LBW, VLBW and suffer from early neonatal death. Conclusion: This study showed that the patients with abnormal umbilical cord have significantly higher rates of adverse neonatal and maternal outcomes.