What are the other Names for this Condition? (Also known as/Synonyms)

• Long Cord

What is Long Umbilical Cord? (Definition/Background Information)

• The length of the umbilical cord is important, since it can affect fetal growth and development. The cord length can also affect the outcome of the pregnancy
• On an average, the umbilical cord length is between 55 and 60 cm. A Long Umbilical Cord is usually defined as an umbilical cord that measures over 80 cm in length
• The placenta is an organ that connects the developing fetus to the uterine wall. It is a disc shaped reddish brown structure that connects the fetus to the mother through the umbilical cord
• The umbilical cord contains two umbilical arteries and one umbilical vein, providing a connection between maternal and fetal blood circulation
• The normal function of placenta is to supply nutrients and oxygen to the fetus from the mother’s blood and remove wastes from the fetal body
• Long Umbilical Cord has been associated with excessive knotting of the cord, umbilical cord torsion, and umbilical cord prolapse (which is a medical emergency)
• An appropriate treatment is necessary for Long Umbilical Cord, in order to have an optimal outcome. The prognosis is dependent upon the severity of the condition and the complications that develop
• Long Umbilical Cord may not be entirely prevented. However, some risk factors may be avoided, such as smoking and alcohol consumption during pregnancy. Also, diabetes in the mother has to be kept under control, to minimize the risk

Who gets Long Umbilical Cord? (Age and Sex Distribution)

• Studies have shown that a Long Umbilical Cord is observed in about 7% of all pregnancies. It may occur in pregnant women of all ages
• Women who are pregnant with both male and female fetuses can be affected
• There is no racial, ethnic, or geographical predilection observed

What are the Risk Factors for Long Umbilical Cord? (Predisposing Factors)

The risk factors for Long Umbilical Cord include:

• Large babies
• High body mass index (BMI) of mother or maternal obesity
• History of cigarette smoking during pregnancy
• Maternal diabetes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Long Umbilical Cord? (Etiology)

• The exact cause of Long Umbilical Cord is unknown
• Studies have indicated that a Long Cord is common with single pregnancies than multiple pregnancies (such as twins and triplets)
• This umbilical cord abnormality is associated with a higher incidence of meconium staining
• Research is currently being performed to identify the relevant causative factors

What are the Signs and Symptoms of Long Umbilical Cord?

The signs and symptoms of Long Umbilical Cord may include:

• Obstruction of blood flow causing reduced blood flow to the developing fetus
• Compression of umbilical cord
• There could be an associated polyhydramnios (increased fluid in the gestational sac)
• Wrapping of the Long Umbilical Cord around the fetal parts

How is Long Umbilical Cord Diagnosed?

The diagnosis of Long Umbilical Cord may involve:

• Physical examination along with an evaluation of one’s medical history
• Prenatal ultrasound scan of the developing fetus may reveal Long Umbilical Cord
• A careful examination of the placenta by a pathologist after birth of the child, to macroscopically (gross visual exam) and microscopically analyze the placental tissue may help establish a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Long Umbilical Cord?

Complications due to Long Umbilical Cord may include:

• Preterm labor and delivery
• Fetal distress
• Umbilical cord compression can cause abnormal fetal heart rate
• Formation of true knots
• Cerebral palsy
• Umbilical edema, hemorrhage, and thrombosis that can affect the growing fetus
• A Long Cord can wrap around the fetal neck and choke the developing fetus; in extreme cases, this may result in stillbirth. This condition is known as nuchal cord syndrome

How is Long Umbilical Cord Treated?

There is no specific treatment available for Long Umbilical Cord. However, the following strategies may be useful in obtaining optimal outcomes:

• If a diagnosis of Long Umbilical Cord is established prenatally, then an elective cesarean section (C-section) may be undertaken
• If the diagnosis is made during childbirth, then an emergency C-section may be helpful
• Alternatively, an operative vaginal delivery may have to be performed, if the condition is diagnosed during childbirth. This procedure may be performed using techniques such as forceps delivery and delivery using vacuum extractor
• A careful and periodic monitoring of the pregnancy is necessary, since the presence of Long Umbilical Cord is considered to be a high-risk pregnancy
• In case of a fetal distress, an immediate delivery of the baby should be considered

The healthcare provider may decide on the course of action on a case-by-case basis, analyzing all the health issues that are involved.

How can Long Umbilical Cord be Prevented?

Currently, there are definitive methods available to prevent Long Umbilical Cord. However, the following factors may be considered:

• Avoidance of smoking and the non-consumption of alcohol during pregnancy is beneficial
• Good control of diabetes before and during pregnancy
• Avoiding obesity and overweight conditions
• If the ultrasound scan indicates an umbilical cord of long length, then careful monitoring of the pregnancy (including the fetal heart rate) is necessary and vital for a successful outcome

What is the Prognosis of Long Umbilical Cord? (Outcomes/Resolutions)

The prognosis of Long Umbilical Cord is generally guarded, due to the high rate of complications that may develop.

Additional and Relevant Useful Information for Long Umbilical Cord:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/pregnancy-related-disorders/