Essentials of Abdomino-Pelvic Sonography by Goyal Swati;

Author:Goyal, Swati;
Language: eng
Format: epub
Publisher: Taylor & Francis Group

Causes

1. Maternal diabetes mellitus.

2. Erythroblastosis fetalis.

3. GIT abnormalities such as esophageal and duodenal atresias.

4. CNS abnormalities—anencephaly and so on.

5. Cardiovascular abnormalities.

6. Musculoskeletal abnormalities.

Figure 22.3 Illustrating excessive amniotic fluid.

Congenital mesoblastic nephroma and U/L ureteropelvic junction obstruction may be a/w polyhydramnios.

23

Umbilical Cord and Biophysical Profile

INTRODUCTION

Anatomy

First visualized at 8 weeks as a straight thick structure, when diameter <2 centimeters.

Umbilical artery arises from fetal internal iliac artery. In newborn, it becomes the superior vesical artery and the medial umbilical ligament.

Umbilical vein carries oxygenated blood from the placenta to the fetus through ductus venosus into IVC and to the heart.

Single left umbilical vein becomes ligamentum teres and attaches to the left portal vein.

Ductus venosus becomes the ligamentum venosum in newborns.

Allantois is associated with bladder development, becomes urachus and median umbilical ligament.

Yolk stalk connects the primitive gut to yolk sac. The paired vitelline vessels follow the stalk to provide blood supply to the yolk sac.

Cord normally inserts in the central portion of the placenta. May insert marginally and paramarginally.

Velamentous insertion—Insertion of cord beyond the edge into the free membrane.

Vasa previa—Fetal vessels running across the internal os of the cervix. Inadvertent rupture of vessels during spontaneous labor may prove fatal. Plan C-section.

Average length of the cord—59 centimeters (22–130 centimeters)

Short cord may be a/w aneuploidy, extreme IUGR, and so on.

Excessive cord length a/w asphyxia due to excessive coiling, true knots, cord prolapse, and multiple loops of nuchal cord.

Normally contains two arteries and one vein. Vessels of the cord are surrounded by Wharton’s jelly.

Single umbilical artery (SUA), cord cysts, hernias, hematomas, and masses should be excluded.

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