Placenta
Umbilical cord
Long cord

Author: Paul J. Kowalski, M.D. (see Authors page)

Revised: 17 October 2017, last major update October 2015

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: "Long umbilical cord"
Cite this page: Kowalski, P.J. Long cord. PathologyOutlines.com website. http://pathologyoutlines.com/topic/placentalongcord.html. Accessed December 13th, 2017.
Definition / general
  • Umbilical cord length is variable and those considered as "long cords" are most commonly defined as an umbilical cord exceeding 80 cm in length
Terminology
  • Long cords have alternatively been defined as umbilical cords longer than 70 cm and 100 cm, in some reports
  • Normal cord length is typically 55 - 65 cm
Epidemiology
  • Umbilical cords 80 cm or greater occur in 3 - 7% of live births, while those 100 cm or greater occur in roughly 0.5% of live births
Pathophysiology
  • Fetal movement and cord traction are implicated in long cord development and fetuses with long cords show relative intrauterine hyperkinetic activity
  • Umbilical cords undergo most growth in length by 28 weeks and progressively slow thereafter
  • Genetics may influence cord length as long cords have been documented in subsequent pregnancies
Clinical features
  • Fetal factors include male sex and increased birth weight, with increased complications including cord entanglements, nuchal cords, nonreassuring fetal status during labor and fetal distress
  • Maternal factors implicate multiparity and also include delivery complications, such as umbilical cord prolapse (an obstetric emergency)
  • Associated placental findings include excess knotting (true knots), excessive cord coiling, cord constriction and thrombosis
Diagnosis
  • Cord length is most ideally assessed in the fresh placental specimen due to shrinkage associated with formalin fixation
  • Obstetrician can determine the most accurate cord length, as the pathologist typically does not receive the entire umbilical cord with the submitted placental specimen
Radiology description
  • Long cords can be detected during the prenatal period and be monitored by ultrasonography for adverse clinical sequelae
Case reports
Clinical images

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Wrapped around fetus

Gross description
  • Long umbilical cords can show edema, hemorrhage or thrombosis of umbilical or chorionic vessels
Gross images

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Various images

Microscopic (histologic) description
  • Limited microscopic findings, unless an associated condition (as described above) is present