Correlation between placenta and umbilical cord morphplogy and perinatal outcome in singleton deliveries at term in a Nigerian tertiary health centre
Context: The ability of the fetus to grow and thrive in-utero depends on a number of factors of which the placenta is a contributor. The umbilical cord is an essential organ connecting the fetus to the placenta and a healthy placenta is essential for good perinatal outcome.
Objectives: The study aims at determining the relationship between the morphology of the placenta and umbilical cord and perinatal outcome in singleton deliveries at term in a Nigerian hospital.
Study design:This is a cross-sectional study involving the analysis of placentae and umbilical cords of three hundred and five neonates delivered in the Federal Medical Centre, Owo who met the inclusion criteria. Immediately after each delivery, the umbilical cord was clamped and severed five centimetres from its attachment to the neonate. The rest of the umbilical cord from the cut end to its insertion on the placenta was measured in centimetres and five centimetres of the umbilical cord attached to the neonate was added to get the entire length of the umbilical cord. Other parameters
involving the morphology of the umbilical cord and placentae were also noted.
Outcome measures: Correlation between the morphological parameters of the umbilical cord, placenta and the neonatal factors such as Apgar scores, birth weight, length of the baby, admission into Neonatal Intensive Care Unit and its indication were determined.
Results: Three hundred and five women had their babies' placentae and umbilical cords examined and also had other records complete. There were 270 umbilical cords out of the 305 recruited with normal coiling index range of 0.17-0.20 coils per centimetres giving an incidence of 88.5%. There was a positive correlation between birth weight and placenta weight (r = 0.466; p value <0.001); there was also a positive correlation between birth length and umbilical cord length (r = 0.130; p value <0.024); likewise there was a positive correlation between umbilical cord coiling index and some parameters of assessing perinatal outcome like the Apgar scores at first and fifth minute (r = 0.137; p value 0.024 and r = 0.84; p value 0.167 respectively) while it had a negative correlation with birth weight (r = -0.130;p = 0.024) .
Conclusion: The findings from this study contribute significantly to knowledge and have also helped to establish the correlation between the intrauterine and extrauterine wellbeing.