Diámetro del cordón umbilical y área de los vasos umbilicales: correlación con el peso del recién nacido
Palavras-chave:
Cordón Umbilical, Ultrasonografía, Vasos Umbilicales, Peso al Nacer, Umbilical Cord, Ultrasonography, Umbilical Vessels, Birth WeightResumo
Objetivo: Establecer la correlación entre el diámetro del cordón umbilical y el área de los vasos umbilicales con el peso del recién nacido, en un grupo de gestantes sanas, a término, que acudieron a control en los Servicios de Prenatal, Sala de partos y unidad de ecografía de la Maternidad Concepción Palacios, entre mayo y diciembre de 2020. Métodos: Estudio prospectivo, descriptivo, correlacional y transversal, que incluyó 60 gestantes sanas, a término, con feto único y evolución normal del embarazo. Mediante ultrasonido abdominal se midió el diámetro del cordón umbilical y el área de los vasos umbilicales y se correlacionaron con el peso de los recién nacidos. La correlación entre las variables se realizó con F de Snedecor, de la tabla de análisis de la varianza. Se consideró una significancia del 95 % (p ˂0,05). Resultados: El diámetro medio del cordón umbilical fue 16,9 ± 2,3 mm, el área media de las arterias umbilicales fue 21,2 ± 5,2 mm2 y la de la vena umbilical fue 50,5 ± 12,9 mm2. No hubo relación entre el peso al nacer y el diámetro del cordón umbilical (p =0,868), el área de las arterias umbilicales (p =0,096), ni de la vena umbilical. Tanto el diámetro del cordón umbilical como el área de los vasos umbilicales fueron independientes de la edad materna, la paridad y la edad de gestación. Conclusiones: En este grupo de pacientes no se encontró correlación entre el diámetro del cordón umbilical y el área de los vasos umbilicales, con el peso del recién nacido.
Objective: To establish the correlation between the diameter of the umbilical cord and the area of the umbilical vessels with the weight of the newborn, in a group of healthy, full-term pregnant women who attended control in the Prenatal Service, Delivery Room and ultrasound of the Maternidad Concepción Palacios Hospital; between May and December 2020. Methods: Prospective, descriptive, correlational and cross-sectional study, which included 60 healthy pregnant women, at term, with a single fetus and normal evolution of pregnancy. Abdominal ultrasound measured the diameter of the umbilical cord and the area of the umbilical vessels and correlated with the weight of the newborns. The correlation between the variables was performed with Snedecor’s F, from the analysis of variance table. It was considered a significance of 95% (p ˂0.05). Results: The mean diameter of the umbilical cord was 16.9 ± 2.3 mm, the mean area of the umbilical arteries was 21.2 ± 5.2 mm2 and of the umbilical vein was 50.5 ± 12.9 mm2 . There was no relationship between birth weight and umbilical cord diameter (p= 0.868), umbilical artery area (p= 0.096), or umbilical vein. Both the diameter of the umbilical cord and the area of the umbilical vessels were independent of maternal age, parity and gestational age. Conclusions: In this group of patients, no correlation was found between the diameter of the umbilical cord and the area of the umbilical vessels with the weight of the newborn.
Downloads
Referências
Langman J. Embriología Médica con orientación clínica. Octava edición. Buenos Aires: Editorial Medica Panamericana S.A.; 1981.
Pirofsky B. The determination of blood viscosity in man by a method based on Poiseuille’s law. J Clin Invest. 1953; 32(4):292-98. DOI: 10.1172/JCI102738.
Weissman A, Jakobi P. Sonographic measurements of the umbilical cord in pregnancies complicated by gestational diabetes. J Ultrasound Med. 1997;
(10):691-94. DOI: 10.7863/jum.1997.16.10.691.
Labarrere C, Sebastiani M, Siminovich M, Torassa E, Althabe O. Absence of Wharton’s jelly around the umbilical arteries: an unusual cause of perinatal mortality. Placenta. 1985; 6(6):555-59. DOI: 10.1016/s0143-4004(85)80010-2.
Raio L, Ghezzi F, Di Naro E, Franchi M, Maymon E, Mueller MD, et al. Prenatal diagnosis of a lean umbilical cord: a simple marker for the fetus at risk of being small for gestational age at birth. Ultrasound Obstet Gynecol. 1999; 13(3):176-80. DOI: 10.1046/j.1469-0705.1999.13030176.x.
Ghezzi F, Raio L, Günter-Duwe D, Cromi A, Karousou E, Dürig P. Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord. J Clin Ultrasound. 2005; 33(1):18-23. DOI: 10.1002/jcu.20076.
Qureshi F, Jacques SM. Marked segmental thinning of the umbilical cord vessels. Arch Pathol Lab Med [Internet]. 1994 [consultado 7 de febrero de 2020]; 118(8):826-30. Disponible en: https://pubmed.ncbi. nlm.nih.gov/8060234/
Ghezzi F, Raio L, Di Naro E, Franchi M, Buttarelli M, Schneider H. First-trimester umbilical cord diameter: a novel marker of fetal aneuploidy. Ultrasound Obstet Gynecol. 2002; 19(3):235-39. DOI: 10.1046/j.1469-0705.2002.00650.x.
Axt-Fliedner R, Schwarze A, Kreiselmaier P, Krapp M, Smrcek J, Diedrich K. Umbilical cord diameter at 11-14 weeks of gestation: relationship to nuchal translucency, ductus venous blood flow and chromosomal defects. Fetal Diagn Ther. 2006; 21(4):390-95. DOI:
1159/000092472.
Cromi A, Ghezzi F, Di Naro E, Siesto G, Bergamini V, Raio L. Large cross-sectional area of the umbilical cord as a predictor of fetal macrosomia. Ultrasound Obstet Gynecol. 2007; 30(6):861-66. DOI: 10.1002/uog.5183.
Raio L, Ghezzi F, Di Naro E, Franchi M, Bolla D, Schneider H. Altered sonographic umbilical cord morphometry in early-onset preeclampsia. Obstet Gynecol. 2002; 100(2):311-16. DOI: 10.1016/s0029- 7844(02)02064-1.
Sun Y, Arbuckle S, Hocking G, Billson V. Umbilical cord stricture and intrauterine fetal death. Pediatr Pathol Lab Med. 1995; 15(5):723-32. DOI: 10.3109/15513819509027008.
Goynumer G, Ozdemir A, Wetherilt L, Durukan B, Yayla M. Umbilical cord thickness in the first and early second trimesters and perinatal outcome. J Perinat Med. 2008; 36(6):523-26. DOI: 10.1515/JPM.2008.087.
Hadlock FP, Harrist RB, Carpenter RJ, Deter RL, Park SK. Sonographic estimation of fetal weight. The value of femur length in addition to head and abdomen measurements. Radiology. 1984; 150(2):535-40. DOI: 10.1148/radiology.150.2.6691115.
Moore TR, Cayle JE. The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol. 1990; 162(5):1168-73. DOI: 10.1016/0002-9378(90)90009-v.
Predanic M, Perni SC, Chasen ST. The umbilical cord thickness measured at 18-23 weeks of gestational age. J Matern Fetal Neonatal Med. 2005; 17(2):111-16. DOI: 10.1080/14767050500042824.
Lacunza Paredes RO. Área del cordón umbilical medida por ecografía como predictor de macrosomía fetal. Rev Peru Ginecol Obstet [Internet]. 2013 [consultado 22 de enero de 2020]; 59(4):247-254. Disponible en: http://www.scielo.org.pe/scielo.php?script= sci_arttext&pid=S2304-51322013000400003
Weissman A, Jakobi P, Bronshtein M, Goldstein I. Sonographic measurements of the umbilical cord and vessels during normal pregnancies. J Ultrasound Med. 1994; 13(1):11-14. DOI: 10.7863/jum.1994.13.1.11.
Raio L, Ghezzi F, Di Naro E, Gomez R, Franchi M, Mazor M, et al. Sonographic measurement of the umbilical cord and fetal anthropometric parameters. Eur J Obstet Gynecol Reprod Biol. 1999; 83(2):131-35. DOI: 10.1016/s0301-2115(98)00314-5.
Ghezzi F, Raio L, Di Naro E, Franchi M, Balestreri D, D’Addario V. Nomogram of Wharton’s jelly as depicted in the sonographic cross section of the umbilical cord. Ultrasound Obstet Gynecol. 2001; 18(2):121-25. DOI: 10.1046/j.1469-0705.2001.00468.x.
Barbieri C, Cecatti JG, Surita FG, Marussi EF, Costa JV. Sonographic measurement of the umbilical cord area and the diameters of its vessels during pregnancy. J Obstet Gynaecol. 2012; 32(3):230-36. DOI: 10.3109/01443615.2011.647129.
Rostamzadeh S, Kalantari M, Shahriari M, Shakiba M. Sonographic measurement of the umbilical cord and its vessels and their relation with fetal anthropometric measurements. Iran J Radiol. 2015; 12(3):e12230. DOI: 10.5812/iranjradiol.12230v2.
Togni FA, Araujo Júnior E, Vasques FA, Moron AF, Torloni MR, Nardozza LM. The cross-sectional area of umbilical cord components in normal pregnancy. Int J Gynaecol Obstet. 2007; 96(3):156-61. DOI: 10.1016/j. ijgo.2006.10.003.
Ross JA, Jurkovic D, Zosmer N, Jauniaux E, Hacket E, Nicolaides KH. Umbilical cord cysts in early pregnancy. Obstet Gynecol. 1997; 89(3):442-45. DOI: 10.1016/S0029-7844(96)00526-1.
