Umbilical cord pathology: what lies beyond routine ultrasound examination in cases of fetal congenital heart disease

DOI

https://dx.doi.org/10.18565/aig.2024.195

Yarygina T.A., Gasanova R.M., Marzoeva O.V., Sypchenko E.V., Leonova E.I., Lyapin V.M., Shchegolev A.I., Gus A.I.
1) Academician V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia; 2) A.N. Bakulev Scientific Center for Cardiovascular Surgery, Ministry of Health of Russia, Moscow, Russia; 3) Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia; 4) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

The weight and condition of a newborn with a heart defect are important factors that determine the early and long-term results of cardiac surgery and are strictly dependent on intrauterine hemodynamics throughout the entire period of pregnancy. The pathologic structure of the umbilical cord associated with a high risk of perinatal hypoxia, growth retardation, and fetal death is detected in a significant proportion of fetal cardiovascular anomalies.
The article presents a review of the literature on the modern capabilities of ultrasound in identifying umbilical cord pathology during pregnancy with fetal cardiac anomalies. This paper examines the incidence of various features of the umbilical cord structure in the general population and in cases of fetal heart defects. It also discusses the pathologic contribution of each of the anomalies to the hemodynamics of the uteroplacental system, and possible clinical manifestations that influence obstetric tactics. The article describes a range of clinically significant variants of abnormalities of the umbilical cord, including structural, attachment, length, and diameter abnormalities, as well as pathologic torsion and formation of knots.
Conclusion: The necessity of multiparametric assessment of the umbilical cord structure during ultrasound examination in cases of fetal congenital heart disease is discussed. The results of such assessment will contribute to the development of individual tactics of pregnancy management, including the choice of the optimal time, method and term for delivery. The quality of life can be improved and life expectancy of the future patient can be increased.

Authors’ contributions: Yarygina T.A., Gasanova R.M., Shchegolev A.I., Gus A.I. – developing the concept and design of the study; Yarygina T.A., Marzoeva O.V., Leonova E.I., Lyapin V.M., Sypchenko E.V. – writing the text; Yarygina T.A., Marzoeva O.V., Leonova E.I., Lyapin V.M., Sypchenko E.V., Shchegolev A.I. – collecting and processing the material; Gasanova R.M., Shchegolev A.I., Gus A.I. – editing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study has been performed within applied research 123020300017-1.
For citation: Yarygina T.A., Gasanova R.M., Marzoeva O.V., Sypchenko E.V., Leonova E.I., Lyapin V.M.,
Shchegolev A.I., Gus A.I. Umbilical cord pathology: what lies beyond routine ultrasound examination
in cases of fetal congenital heart disease.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (9): 12-21 (in Russian)
https://dx.doi.org/10.18565/aig.2024.195

umbilical cord

single umbilical cord artery

vasa previa

umbilical cord knot

umbilical cord coiling

fetal hypoxia

fetal growth restriction

congenital heart disease

Full text (in Russian)

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Received 08.08.2024

Accepted 09.09.2024

Tamara A. Yarygina, PhD, Head of the Ultrasound Diagnostics Department, Academician V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, 101000, Russia, Moscow, Pokrovka str., 22a; Researcher at the Perinatal Cardiology Center, A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of Russia, 121552, Russia, Moscow, Roublyevskoe Shosse, 135; Associated Professor at the Department of Ultrasound Diagnostics of the Faculty of Continuing Medical Education of the Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 127015, Russia, Moscow, Pistsovaya str., 10,
+7(495)414-78-75, tamarayarygina@gmail.com, https://orcid.org/0000-0001-6140-1930
Rena M. Gasanova, Dr. Med. Sci., Head of the Perinatal Cardiology Center, A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia, 121552, Russia, Moscow, Roublyevskoe Shosse, 135; Physician of Ultrasound Diagnostics, Department of Ultrasound and Functional Diagnostics,
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow,
Academician Oparin str., 4, rmgasanova@bakulev.ru, https://orcid.org/0000-0003-3318-1074
Olga V. Marzoeva, PhD, Doctor of Ultrasound Diagnostics, Researcher at the Perinatal Cardiology Center, A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia, 121552, Russia, Moscow, Roublyevskoe Shosse, 135, +7(495)414-78-75, ovmarzoeva@bakulev.ru, https://orcid.org/0000-0003-4475-0105
Elena V. Sypchenko, PhD, Doctor of Ultrasound Diagnostics at Perinatal Cardiology Center, A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia, 121552, Russia, Moscow, Roublyevskoe Shosse, 135, +7(495)414-78-75, evsypchenko@bakulev.ru, https://orcid.org/0000-0002-8809-7913
Elena I. Leonova, Doctor of Ultrasound Diagnostics at Perinatal Cardiology Center, A.N. Bakulev National Medical Research Center for Cardiovascular Surgery,
Ministry of Health of Russia, 121552, Russia, Moscow, Roublyevskoe Shosse, 135, +7(495)414-78-75, eileonova@bakulev.ru https://orcid.org/0000-0002-6140-7950
Vyacheslav M. Lyapin, Pathologist of the Pathology Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Academician Oparin str., 4, +7(495)531-44-44, v_lyapin@oparina4.ru
Alexander I. Shchegolev, Dr. Med. Sci., Professor, Head of the 2nd Pathoanatomical Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Academician Oparin str., 4, +7(495)531-44-44, ashegolev@oparina4.ru,
https://orcid.org/0000-0002-2111-1530
Alexander I. Gus, Dr. Med. Sci., Professor, Chief Researcher at the Department of Ultrasound and Functional Diagnostics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Academician Oparin str., 4; Head of the Department of Ultrasound Diagnostics of the Faculty of Continuing Medical Education of the Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 127015, Russia, Moscow, Pistsovaya str., 10, a_gus@oparina4.ru, https://orcid.org//0000-0003-1377-3128
Corresponding author: Tamara A. Yarygina, tamarayarygina@gmail.com

Umbilical cord pathology: what lies beyond routine ultrasound examination in cases of fetal congenital heart disease

Yarygina T.A., Gasanova R.M., Marzoeva O.V., Sypchenko E.V., Leonova E.I., Lyapin V.M., Shchegolev A.I., Gus A.I.

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