الفهرس 
Embryology and anatomyOnly 14 pages are availabe for public view
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Abstract
Objectives: To generate a nomogram of the umbilical cord morphometry as measured by ultrasonography during normal pregnancies in Egyptian females and to assess the predictive value of umbilical cord morphometry in certain pregnancy complications associated with abnormal fetal growth as pre-eclampsia, IUGR and DM. Methods: This study was performed in Mansoura university Hospital , Obstetric and Gynecology department from may 2005 to July 2008.The patients were classified into 4 groups, the 1st group consists of 370 normal pregnancies between 20 and 42 weeks of gestation , the 2nd group consists of 136 patients with severe pre-eclampsia at a gestational age greater than 20 weeks, the 3rd group consists of 130 abnormal pregnancies complicated by fetuses small for gestational age (SGA) and the 4th group consists of 113 abnormal pregnancies complicated by diabetes mellitus. Fetal umbilical artery Doppler ultrasound and biophysical profile was performed to all cases above 30 weeks of gestation. The measurements of umbilical cord were performed near its entrance to fetal abdominal wall for standardization . A cross-sectional view from free loop of umbilical cord was obtained and the diameter of the umbilical cord was measured as outer-to-outer border, while the vessels were measured as inner-to-inner diameter. These data was computed to obtain areas of the umbilical cord and its vessels. The surface area of Wharton’s Jelly was computed by subtracting the areas of both umbilical vein and two arteries from the cross-sectional area of the umbilical cord. Mean and SD were used to describe data. Chi Square test was used to test for association between different variables. Curve fitting was used to select the best regression model for the relation between the different variables and GA and the 10th ,50th and 90th percentile predicted from the normal group were used for determination of the outliers in each group. Results: Generation of umbilical cord nomogram was done and shows that there is a gradual increase in the values of umbilical cord and its components with the advance in GA. Statistically significant reduction of values of umbilical cord and its components was observed in PET and IUGR groups while statistically significant increase of these values in diabetic group when compared with normal group at the same GA (p<0.001). Conclusions: Obtaining a cross-sectional view of fetal umbilical cord should be an integral part of the routine ultrasonic examination done during normal pregnancy. Ultrasonic measurements of umbilical cord and its components is an effective , safe , non-invasive and new method for prediction of high risk pregnancies (PET, IUGR and diabetics).