AbstractBackground and aims
Low birth weight infants are at high risk of perinatal complications and death to normal or large infants. Umbilical cord abnormalities are associated with this group of infants due to chronic aggravation of umbilical blood flow. We want to establish the anatomical features of umbilical cord who can predict the outcome of newborn.Materials and methods
Analytical study of low birth weight newborns, with a duration of 3 years conducted in National Institute of Mother and Child Health ‘Alessandrescu-Rusescu’, Neonatology Clinic. Were monitored type of conception and delivery, umbilical cord anatomic features, Apgar score, need for invasive resuscitation at birth (oxygen – positive pressure ventilation, achieving PEEP with T piece resuscitator, intubation), outcome of newborns.Results
Low birth weight infants studied came from 90% investigated preganat women, multigestation 62,5% and primiparous 67,5%; naturally conceived in 78,3% cases and 21,6% in vitro fertilisation; equal proportion by gender; 43% term newborn, 8,3% between 33–36 weeks of gestation, 39,1% between 28–32 weeks of gestation and 9,1% under 27 weeks of gestational age; number of days oh hospitalisation were above normal in most cases. Cord appearance in this group was normal in 79,1% of cases, lin 9,1%, hypertrophic 10,8%, excess Wharton jelly in 5,8% of cases, meconium stained 3,8%. In the series with meconium stained umbilical cord, maternal hystory was infectious type in 75% of cases, 50% under 27 weeks gestational age, 75% with Apgar score under 1 at 1 minut after birth, and all newborns required resuscitation at birth; those with excess Wharton’s jelly came in 86% of cases from primiparous, 42,8% concevied by in vitro fertilisation and multipe fetuses, all at 28–32 weeks gestational age, need for resuscitation at birth 43%; hypertrophic cord was associated with maternal pathology like placenta praevia 25% and pregnancy hypertenison 25%, all naturally concieved, 50% with gestational weeks between 28 and 32, hospitalisation over one month; lin umbilical cord was associated with 72,7% multigestation of wich 37,5% primiparous, without significant pathology, naturally concevied, 63,6% between 33 and 36 weeks gestational age, 45,1% with Apgar score 5–7 and need for resuscitation at birth.Conclusions
In this situation, we have the confirmation that the features of umbilical cord can be the first clinical exam of low birth weight newborns who could oriented the action of neonatal team and treatment for infants.