|dc.description.abstract||Objective: To determine the shortest umbilical cord length to permit spontaneous vaginal delivery
Methods: This prospective observational study included 166 randomly chosen women, age ≥ 18 years, with no apparent antepartum complications who delivered spontaneously ≥ 37 weeks. The cord was clamped at the maternal introitus immediately at delivery. The cord segment was measured from introitus to placental insertion. We reviewed a recent fetal scan to identify the placental implantation site (fundal or lateral).
Results: The mean cord segment from placental insertion to maternal introitus measured to be 22.4 cm (95% confidence interval, 11 to 32 cm). The segment was 2.1 cm longer (95% confidence interval 0.4 to 3.7 cm) when the placenta was implanted at the uterine fundus rather than laterally (p < .01; one-sided t-test). An excessively short cord segment (< 13 cm) was present in two cases (1.2 %) with a lateral placental implantation and no case with a fundal implantation.
Conclusion: The uterine axis and birth canal are not so long to prevent a spontaneous vaginal delivery in the presence of a short umbilical cord. Placental location does not impede delivery except perhaps when fundal in the presence of an excessively short cord.||en_US