Abstract:

Background: The perinatal morbidity and death are largely influenced by the umbilical cord. In Tanzania, the infant mortality rate for 2022 is 35.576 per 1,000 live births, with one-third of neonatal deaths attributed to birth asphyxia. Abnormalities in the umbilical cord are the third most common structural cause of acute intrapartum fetal hypoxia, after premature placental detachment and the administration of oxytocin during delivery. This study found links between anomalies of the umbilical cord and maternal health issues, including hypertension and chronic illness. Additionally, it looked at the relationship between shorter umbilical cords and greater rates of instrumental and emergency cesarean deliveries, which emphasizes the necessity of careful labor monitoring to guarantee safe delivery practices. The results emphasize the value of umbilical cord assessments in standard prenatal examinations, guiding professional practices and recommendations for handling pregnancies with anomalies and improving maternal and neonatal outcomes.

Methodology: This study was a cross-sectional study of minimally 384 women giving birth in labor ward at BMC Hospital in Mwanza. Sample of umbilical cord (5cm from the fetal cord insertion to the placental insertion) was collected promptly after delivery, and measured. Questionnaire and checklist were utilized for data collection and analysis was done using STATA.

Results: A total of 384 participants were included in this study. The prevalence of abnormal umbilical cord was 79%. Abnormal cord length accounted for 10.4% whereas long cords 5.2%, and short cords 5.2%. Abnormal umbilical cord diameter accounted for 65.1% with thin cord accounting for 64.3% and thick cord was 0.8%. The number of cord arteries was one in 18.5% of the participants while number of veins were two for the 18.7% of participants (82.3%). Maternal factors such as hypertension and chronic illness are associated with cord length. Maternal age, parity, maternal hypertension, and gestational DM are associated with cord diameter. Abnormal blood vessels were associated low Apgar score at 1 and 5 mins. Short umbilical cord was associated with instrumental and emergency cesarean delivery.

Conclusion: In conclusion, the study reveals a high prevalence of abnormal umbilical cords (79%), significantly linked to maternal health factors. Abnormalities in cord length and diameter correlate with labor complications and low Apgar scores, underscoring the necessity for thorough monitoring of umbilical cord characteristics during prenatal care to minimizing negative neonatal outcomes such as birth hypoxia, low birth weight, and the need for instrumental or emergency caesarean births