Placenta
Gross / macroscopic variations and conditions
Umbilical cord
Long cord
Author: Paul J. Kowalski, M.D.
Last author update: 1 October 2015
Last staff update: 28 October 2020
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: "Long umbilical cord"
Table of Contents
Definition / general | Terminology | Epidemiology | Pathophysiology | Clinical features | Diagnosis | Radiology description | Case reports | Clinical images | Gross description | Gross images | Microscopic (histologic) descriptionCite this page: Kowalski PJ. Long cord. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/placentalongcord.html. Accessed June 8th, 2023.
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
- Second trimester miscarriage and umbilical cord knot (Clin Exp Obstet Gynecol 2013;40:448)
- Massive fetal thrombotic vasculopathy associated with excessively long umbilical cord and fetal demise (Pediatr Dev Pathol 2010;13:112)
- Fetal distress associated with excessively long (160 cm) umbilical cord (Arch Gynecol Obstet 1994;255:99)
Clinical images
Images hosted on other servers:
Wrapped around fetus
Gross description
- Long umbilical cords can show edema, hemorrhage or thrombosis of umbilical or chorionic vessels
Gross images
Images hosted on other servers:
Various images
Microscopic (histologic) description
- Limited microscopic findings, unless an associated condition (as described above) is present
