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Altered Sonographic Umbilical Cord Morphometry in Early-Onset Preeclampsia

From the Department of Obstetrics and Gynecology, University of Berne-Inselspital, Bern, Switzerland;Department of Obstetrics and Gynecology, University of Insubria-Ospedale di Circolo, Varese, Italy; and Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.

Address reprint requests to: Luigi Raio, MD, University of Berne-Inselspital, Department of Obstetrics and Gynecology, Schanzeneckstrasse 1, Bern, Switzerland; E-mail: luigi.raio @insel.ch.

OBJECTIVE: To determine whether the sonographic morphometry of the umbilical cord components is different in preeclamptic compared with healthy pregnant women.

METHODS: Consecutive women admitted after 20 weeks’ gestation with the diagnosis of preeclampsia and whose fetus was normally grown (cases) were included in the study. Each case was matched to a healthy pregnant woman (controls) who had ultrasonography at the same gestational age (± 3 days). The sonographic cross-sectional areas of the umbilical cord and umbilical vessels were obtained in all patients and plotted on reference ranges. The umbilical artery resistance index was measured in all patients with preeclampsia.

RESULTS: Twenty-five preeclamptic women were enrolled. The proportion of cases with a lean (below the tenth centile) umbilical cord was higher in cases than in controls (12 of 25 versus 1 of 25, P < .001). The Wharton’s jelly area was lower in cases than in controls (median 105.8 mm² [range 49.6–212.9 mm²] versus 138.7 mm² [79.7–226.6 mm²], P = .024). The umbilical vein area was less in cases than in controls (median 29.2 mm² [range 8.0–52.8 mm²] versus 37.4 mm² [13.8–70.8 mm²], P = .032). The proportion of patients with a lean umbilical cord was higher among those with early-onset preeclampsia than in those with late-onset preeclampsia (12 of 19 versus 0 of 6, P = .014).

CONCLUSION: Early-onset preeclampsia frequently is associated with reduced Wharton’s jelly area and umbilical vein area compared with normal pregnancy. Sonographic umbilical cord morphometry might have clinical value for prompt identification of women at risk for preeclampsia.

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