Impact of umbilical cord pathology on perinatal outcomes: risk factors and clinical implications

Abstract

Introduction. Umbilical cord pathology can contribute to neonatal asphyxia, stillbirth, and postnatal death in numerous cases. However, the diagnosis of umbilical cord pathology remains imperfect, and its impact on pregnancy course and outcome is often underestimated. Therefore, prenatal diagnosis of umbilical cord pathology is becoming increasingly important in preventing intra- and postnatal morbidity and mortality. Early detection of these abnormalities enables the development of necessary strategies for optimal pregnancy and delivery management. Material and methods. The study included 190 patients divided into 2 groups: L1 – 95 patients with UC abnormalities, and L0 – 95 with a normal UC. A p-value of less than 0.05 was regarded as statistically significant. Results. The development of umbilical cord pathology was frequently observed in pregnant women exposed to harmful workplace factors (psychological and emotional stress, p=0.01), harmful habits (smoking, p=0.04), and primiparas (p=0.005) with complicated gynecological and somatic histories, as well as those with a history of UC pathology in previous pregnancies (p<0.0001). Pregnancy and labor progression in patients with cord pathology showed a high rate of complications compared to control group, including urinary tract disorders (p=0.02), preterm labor at 27-28 weeks (p=0.01), polyhydramnios, which was ten times more frequent (p=0.002), and fetal growth restriction (p=0.02). In the study group, a prolonged second stage of labor was observed (p=0.01), along with acute fetal hypoxia, which required urgent pregnancy termination (p=0.01) through vacuum extraction (p=0.0009) or C-section (p=0.04). Conclusions. The analysis of the anamnestic and clinical peculiarities of the perinatal period in patients with UC pathology, compared to pregnant women without this pathology, confirmed that this commonly encountered obstetric condition represents a considerable risk factor for perinatal complications.