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Hundereds of carefully categorized obgyn illustrations, and real life ultrasound scan images and clips from clinical practice with desription, user comments lightbox..etc.
|Umbilical Cord in gallery - Umbilical cord and doppler ultrasound images and clips showing normal umbilical cord vessels, insertion, true knot, umbilical cord cyst, cord aroung the fetal neck ...etc.|
What to see in the umbilical cord?
1- Check there are 3 vessels in the umbilical cord you may also check the course of umbilical vessels, trace the umbilical vein till you can identify the ductus venosus and check the umbilical arteries on both sides of the urinary bladder. The former helps you later to easily identify the DV in cases of fetal growth restriction and the latter helps you differentiate an abdominal cyst from a full fetal urinary bladder
2- Check the insertion site both in the placenta and fetal abdomen
- Placental insertion: May be eccentric, marginal or velamentous
- Abdominal insertion site checked for defect in the abdominal wall:
- Gastroschisis: Para-umbilical defect usually to the right side of an intact umbilical cord. The defect is usually small but a complete defect with absence of all layers on the abdominal wall resulting in "free bowel" herniating into the amniotic sac with no sac covering.
- Omphalocele: Midline abdominal wall defect with herniation of abdominal content covered with amnion and peritoneum. THe umbilical cord inserts into the membranes.
3- Near term check for cord around the neck and for knots.
- Cord around the neck is easily diagnosed with careful color doppler mapping where a loop of umbilical cord can be traced surrounding fetal neck (this just dictates careful CTG tracing during labor but does not warrant caesarean birth) -
- True knot if ever diagnosed there is no recommendation as for the mode of delivery since true knots are not diagnosed they are only suspected. Finding true knot I would recommend counselling the patient between the option of c-section birth at term, day light induction of labor under close monitoring at term or await spontaneous labor with risk of fetal demise.
- Cord presentation as well should be ruled out especially in cases of breech presentation and cases of presenting part not applied to the cervix.
4- Umbilical Artery Doppler explained in this presentation and under "fetal doppler' is discussed in details.