Predanic Mladen, Perni Sriram C, Chasen Stephen, Chervenak Frank A
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 525 E 68th St, Suite M-704, New York, NY 10021, USA.
J Ultrasound Med. 2004 Sep;23(9):1177-83; quiz 1185. doi: 10.7863/jum.2004.23.9.1177.
To evaluate and compare umbilical cord thickness of aneuploid fetuses with umbilical cord diameter nomograms generated from euploid fetuses between 14 and 23 weeks' gestational age.
A retrospective study was conducted in which 56 fetuses and neonates had diagnoses of abnormal karyotypes, of which 46 fetuses had numerical chromosomal abnormalities. Among these cases, 26 subjects with adequate umbilical cord sonographic images were included in the study. The umbilical cord thickness was measured and plotted against the umbilical cord diameter nomogram that was generated from previously published data.
From 26 evaluated fetuses and neonates, in 14 subjects (53.8%), the umbilical cord thickness was greater than the 95th percentile for gestational age. A thick umbilical cord was observed in 57.8% of fetuses with trisomy 21 and 50% of subjects with trisomy 18 and monosomy 45,XO. One fetus with trisomy 2 had umbilical cord thickness within the normal range. The largest number of aneuploid fetuses with thick umbilical cords (87.5%) was observed between 16 and 17 gestational weeks.
Aneuploid fetuses have thicker umbilical cords than euploid fetuses. The umbilical cord thickness can be related to an increased amount of Wharton jelly. Because of the smaller number of thick umbilical cords in aneuploid subjects at later gestational ages, we speculate that abnormal cord thickness has a natural tendency toward its own resolution with the advancement of gestational age.
