Study of length of umbilical cord and fetal outcome: a study of 1000 deliveries

Shiva Kumar H. C., Chandrashekhar T. Tharihalli, Chandrashekhar K., Suman F. Gaddi


Background: Human embryo develops inside the body of the mother. One of the important part of the fetoplacental unit is the umbilical cord. The umbilical cord is the lifeline of the fetus. Objective of present study was to investigate the correlation of umbilical cord length with fetal parameters like APGAR score, sex, weight, and length, and its effect on labor.

Methods: This prospective study conducted in the Department of OBG of VIMS, Bellary, from 1st February 2016 to 31st January 2017. The 1000 pregnant women of >37 weeks were studied following delivery for length of umbilical cord, any loop around neck, trunk, shoulder and number of loops of cord; knots of cord etc. Fetal parameters recorded were sex, weight, and length of the newborn and APGAR score at 1 and 5 min.

Results: Cord length varied from 22 to 126 cm. The mean cord length was 66 cm (±10 cm). Maximum cases have cord length of 61and 70 cm. Lower 5th percentile and upper 5th percentile considered as short and long cord. Short-cord group was associated with significantly higher (p<0.05) incidence of LSCS cases. The incidence of all types of cord complications increases as the cord length increases (p<0.001). Nuchal cords had higher mean cord length and as the number of loops in a nuchal cord increases to two or more loops, the operative interference and fetal heart abnormalities increases. Fetal heart rate abnormalities and birth asphyxia increase with extremes of cord length (p<0.001).

Conclusions: Short and long cords are associated with increased incidence of cord complications, operative interference, intrapartum complications, increased fetal heart rate abnormalities, and birth asphyxia. But cord length did not vary according to the weight, length, and sex of the baby.


Birth asphyxia, Fetal distress, Umbilical cord

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Misra R. Ian Donald’s Practical obstetric problems. Published by Wolters Kluwer. 1994;417.

Krakowiak P, Smith EN, de Bruyn G, Lydon-Rochelle MT. Risk factors and outcomes associated with a short umbilical cord. Obstet Gynecol. 2004;103:119-27.

Yadav BB, Darade RV, Mahadar NA. Correlation of umbilical cord length with foetal and maternal outcome. JEMDS. 2013;2(4):412-8.

Suzuki S, Fuse Y. Length of the umbilical cord and perinatal outcome in Japanese singleton pregnancies delivered at greater than or equal to 34 weeks gestation. J Clin Gynecol Obstet. 2012;1(4-5):57-62.

Georgiadis L, Keski-Nisula L, Harju M, Raisanen S. Umbilical cord length in singleton gestation: a Finnish population based retrospective register study. Placenta. 2014;5(4):275-80.

Nanadini B, Jain D, Bhatia BG, Ara S, Dhotre J. Relationship between umbilical cord length and maternal and fetal outcome. Paripex-Indian J Res. 2015;4(7).

Balkawade NU, Shinde MA. Study of length of umbilical cord and fetal outcome: a study of 1,000 deliveries. J Obstet Gynecol India. 2012;62(5):520-5.

Yampolsky M, Salafia CM, Shlakhter O, Haas D, Eucker B, Thorp J. Centrality of the umbilical cord insertion in a human placenta influences the placental efficiency. Placenta. 2009;30(12):1058-64.

LaMonica GE, Wilson ML, Fullilove AM, Rayburn WE. Minimum cord length that allows spontaneous vaginal delivery. J Reprod Med. 2008;53(3):217-9.

Shrestha NS, Singh N. Nuchal cord and perinatal Outcome. Kathmandu Univ Med J. 2007;19:360-3.

Rogers MS, Ip YW, Qin Y, Rogers SM, Sahota D. Relationship between umbilical cord morphology and nuchal cord entanglement. Acta Obstet Gynecol Scand. 2002;82:32-7.

Algreisi F, Brown R, Shrim A, Albasri SF, Shamarani H, AlZoubiadi A. Effect of long and short umbilical cord on perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5(12):4228-31.

Begum AA, Sultana H, Hasan R, Ahmed M. A clinical study of fetal outcome in cases of nuchal cord. JAFMC. Bangladesh. 2011;7(1):25-7.

Elarbah I, Elbareg A, Essadi F, Algharaz A, Adam I. Umbilical cord length in singleton gestation at Misurata Hospital Libya. J Obstet Gynaecol. 2014;4(1):657-60.

Atalla RK, Abrams K, Bell SC, Taylor DJ. Newborn acid-base status and umbilical cord morphology. Obstet Gynecol. 1998;92(5):865-8.