Umbilical cord morphology in pregnancies complicated by IUGR in cases of tobacco smoking and pregnancy-induced hypertension.

OBJECTIVE: The aim of this study was to determine the characteristic features of the umbilical cord morphology in selected cases of intrauterine growth restriction (IUGR): tobacco smoking, pregnancy-induced hypertension and idiopathic IUGR.

MATERIALS AND METHODS: 136 pregnant women were included in the study - 86 patients with IUGR (IUGR group) and 50 women with uncomplicated course of pregnancy (control group). In the IUGR group 31 women were smokers, 27 suffered from pregnancy-induced hypertension, and 28 had an unknown reason for IUGR. Each of them underwent ultrasound examination to measure fetal growth and to assess morphological parameters of the umbilical cord.

RESULTS: Significant differences between the control group and the whole IUGR group in terms of the diameter of the umbilical cord and diameter of the umbilical vein - smaller diameters in the IUGR group than in the control group. Significant differences among IUGR subgroups in terms of area of Wharton's jelly and diameters of the umbilical cord, vein and artery. Significant difference in the length of the uncoiled section among the IUGR subgroups.

CONCLUSIONS: 1. The umbilical cord in IUGR and concomitant tobacco smoking is hyper-coiled with coiling index independent of fetal weight and high content of Wharton's jelly. 2. The umbilical cord in IUGR and concomitant pregnancy-induced hypertension is thinnest with thinnest vessels and the smallest content of Wharton's jelly. 3. The assessment of umbilical cord morphology should become an integral part of ultrasound exam in pregnancies complicated by IUGR.