The change of umbilical cord components in intrauterine growth restriction comparative with normal growth fetuses by using sonographic measurement.

OBJECTIVE To determine the diameter changes of umbilical cord components in intrauterine growth restriction (IUGR) fetuses comparative with normal growth fetuses by using the ultrasonogram. MATERIAL AND METHOD A cross sectional study was performed with 140 singleton pregnant women who was attended at Maternal-Fetal Medicine unit, Thammasat University Hospital between June, 2007 to May, 2009. The fetuses were between the gestational ages of 24 to 37 weeks at the time of data collection. Seventy pregnant women with IUGR fetuses and 70 pregnant women with normal growth (Appropriate for Gestational Age, AGA) fetuses were included. The sonogram of the umbilical cord, umbilical artery and umbilical vein diameter and circumference were obtained at the free loop of cord. Fetal weights were estimated by calculation in all cases. IUGR was defined as a fetus having an estimated fetal weight below the 10th percentile for the gestational age at time of the sonographic measurements. RESULTS The mean age of the patients were 27.03 and 31.86 years in IUGR group and AGA group, respectively. The mean birth weight of the fetuses was 2153.60 +/- 386.13 gm and 3118.16 +/- 353.28 gm in IUGR fetuses and AGA fetuses, respectively. The result demonstrated the expected progressive increase of the umbilical cord circumference and diameter as a function of gestational age in AGA fetuses. These changes were not observed in the umbilical cord of IUGR fetuses. It was a contradictory finding that the measurement values from umbilical artery and umbilical vein IUGR fetuses were neither consistent nor correlated with fetal age. CONCLUSION The ultrasonogram of the umbilical cord component demonstrated the increasing of umbilical cord circumference and diameter along with an increasing of gestational age in the AGA fetuses. These findings might be useful for further studies, such as early screening or prediction of adverse pregnancy outcome for high risk women.