Abnormal Umbilical Cord 、 Puerperium

Women’s Hospital School of Women’s Hospital School of Medicine Zhejiang UniversityMedicine Zhejiang University

Wang ZhengpingWang Zhengping

Abnormal Umbilical Cord

Abnormal cord length Cord entanglement Knot of cord Torsion of cord Abnormal cord insertion Cord presentation and cord prolapse Single umbilical artery

Abnormal cord length

Normal cord length is 30-70cm, averagely 50cm Short cord: <30cm is defined as short cord, may

lead to fetal distress, placental abruptio, prolonged labour

Long cord: >80cm is defined as long cord, higher occurrence of cord around neck, cord around body, cord knot, cord prolapse and cord compression

Abnormal cord insertion

Marginal cord insertion into placenta, known as racket placenta

Cord insertion onto membrane, runs between chorionic membrane and amniotic membrane before inserting into placenta, known as velamentous cord insertion

Blood vessels on membrane passing internal cervical os anterior to fetal presenting part, known as vasa previa

Velamentous cord insertion, commonly seen with single umbilical artery

In vasa previa rupture, blood loss of 200-300ml can lead to fetal demise

velamentous cord insertion

velamentous cord insertion

Cord presentation and Cord prolapse

Cord located anterior or lateral to fetal presenting part, known as cord presentation, also known as occult cord prolapse

At membrane rupture, cord prolapse out of cervical os, descending into vagina, known as cord prolapse

Cord prolapse is life-threatening to the fetus

Cord presentation

Cord prolapse

Knot of cord

Cord entanglement

Cord entanglement

The puerperium and complications

definition puerperium puerperial morbidity puerperial infection late postpartum hemorrhage involution of uterus lochia