DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20200926

Absence of Wharton’s jelly: an association with feto-maternal morbidity

Swati Trivedi, Lata Ratanoo, Shivani Purohit, Prasoon Rastogi

Abstract


Umbilical cord contains two arteries and one vein connecting fetus to the placenta and is responsible for blood flow between the two. It is surrounded by Wharton’s jelly which is a gelatinous substance and functions as adventitia layer of umbilical vessels, thereby providing insulation and protection to the umbilical cord. Umbilical cord abnormalities are associated with poor perinatal outcomes. Very few cases of absent Wharton’s jelly are reported in literature. Ours might be the 8th one in which we did a lower segment caesarean section for meconium stained liquor but the baby died after 12 hours.


Keywords


Meconium stained liquor, Umbilical cord, Wharton’s jelly

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References


Bergman P, Lundin P, Malmstrom T. Mucoid degeneration of the Wharton’s jelly: an umbilical cord threatening foetal life. Acta Obstet Gynecol Scand. 1961;40:372-8.

Labarrere C, Sebastiani M, Siminovich M, Torassa E, Althabe O. Absence of Wharton’s jelly around the umbilical arteries: an unusual cause of perinatal mortality. Placenta. 1985;6:555-9.

Stevenson RE, Hall JG. Human malformations and related anomalies 2nd edition Chapter 35; umbilical cord; 2005:1434.

Thomson LL, Hoo JJ. Linear disruption of umbilical cord: a rare anomaly of the cord associated with acute fetal distress and perinatal death/profound psychomotor retardation. Am J Med Genet. 1996;62:348-9.

Kulkarni ML, Matadh PS, Ashok C, Pradeep N, Avinash T, Kulkarni AM. Absence of Wharton’s jelly around the umbilical arteries. The Indian J Pediatr. 2007;74(8):787-9.

Oliveira CC, Dufloth RM, Coelho KIR. Absence of Wharton's jelly: case report. J Bras Patol Med Lab. 2014;50(6):452-5.

Damasceno EB, de Lima PP. Wharton’s jelly absence: a possible cause of stillbirth. Autopsy Case Reports. 2013;3(4):43.

Di Naro E, Ghezzi F, Raio L, Franchi M, D’Addario V. Umbilical cord morphology and pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2001;96:150-7.

Benirschke K. Obstetrically important lesions of the umbilical cord. J Reprod Med. 1994;39(4):262-72.

Clausen I. Umbilical cord anomalies and antenatal fetal deaths. Obstet Gynecol Surv. 1989;44(12):841-5.

Sun Y, Arbuckle S, Hocking G, Billson V. Umbilical cord stricture and intrauterine fetal death. Pediatr Pathol Lab Med. 1995;15(5):723-32.

Barbieri C, Cecatti JG, Surita FG, Costa ML, Marussi EF, Costa JV. Area of Wharton’s jelly as an estimate of the thickness of the umbilical cord and its relationship with estimated fetal weight. Reprod Health. 2011;8:32-7.

Raio L, Ghezzi F, Di Naro E, Gomez R, Franchi M, Mazor M, et al. Sonographic measurements of the umbilical cord and feftal anthropometric parameters. Eur J Obstet Gynecol Reprod Biol. 1999;83:135-45.

Filiz A, Rahine B, Keskin HL, Esra AK. Positive correlation between the quantity of Wharton’s jelly in the umbilical cord and birth weight. Taiwan J Obstet Gynecol. 2011;50:33-6.