1. Abnormal Umbilical Cord、 Puerperium
Women’s Hospital School of Medicine Zhejiang University
Wang Zhengping

2. Abnormal Umbilical Cord
Abnormal cord length
Cord entanglement
Knot of cord
Torsion of cord
Abnormal cord insertion
Cord presentation and cord prolapse
Single umbilical artery

3. Abnormal cord length
Normal cord length is 30-70cm(30-100cm), averagely50cm( 55cm)
Short cord: <30cm is defined as short cord, may lead to fetal distress, placental abruptio, prolonged labour
Long cord: >80(100cm) is defined as long cord, higher occurrence of cord around neck, cord around body, cord knot, cord prolapse and cord compression

4. Abnormal cord insertion
Marginal cord insertion into placenta, known as racket placenta
Cord insertion onto membrane, runs between chorionic membrane and amniotic membrane before inserting into placenta, known as velamentous cord insertion
Blood vessels on membrane passing internal cervical os anterior to fetal presenting part, known as vasa previa
Velamentous cord insertion, commonly seen with single umbilical artery
In vasa previa rupture, blood loss of ml can lead to fetal demise

7. velamentous cord insertion

8. velamentous cord insertion

9. Cord presentation and Cord prolapse
Cord located anterior or lateral to fetal presenting part, known as cord presentation, also known as occult cord prolapse
At membrane rupture, cord prolapse out of cervical os, descending into vagina, known as cord prolapse
Cord prolapse is life-threatening to the fetus

10. Cord presentation

11. Cord prolapse

12. Knot of cord

13. Cord entanglement

14. Cord entanglement

15. The puerperium and complications definition
puerperial morbidity
puerperial infection
late postpartum hemorrhage
involution of uterus
lochia

16. THANKS