Placenta
Gross / macroscopic variations and conditions
Umbilical cord
Short cord
Author: Paul J. Kowalski, M.D.
Editorial Board Member: Carlos Parra-Herran, M.D.
Last author update: 1 July 2017
Last staff update: 19 May 2021
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Placenta (umbilical cord [title]) (short cord)
Table of Contents
Definition / general | Essential features | Terminology | Epidemiology | Etiology | Pathogenesis | Clinical features | Case reports | Gross description | Gross images | Microscopic (histologic) description | Board review style question #1 | Board review style answer #1Cite this page: Kowalski PJ. Short cord. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/placentashortcord.html. Accessed June 1st, 2023.
Definition / general
- Decrease in the absolute length of the umbilical cord
Essential features
- Variably defined but short umbilical cords measure less than 35 cm in absolute length
- Usually best measured at the time of delivery, as the umbilical cord tends to slightly shrink in the few hours following delivery and a small portion of the umbilical cord is left attached to the infant following delivery
- The length of the umbilical cord received for pathologic evaluation must always be recorded; nonetheless, the diagnosis of short cord can only be made if the absolute length is known (measured at the time of delivery)
Terminology
- Absolute length of the umbilical cord can vary from its functional length, such as when additional pathology limits the length of the physical cord (as seen with umbilical knots, nuchal cords, cord entanglements, etc.)
Epidemiology
- Incidence is 1 - 2% when using < 35 cm as a cutoff; incidence is < 1% when using < 32 cm as a cutoff
Etiology
- Uncertain but a propensity for shorter cords (or cord length in general) in some patients suggest a genetic etiology
Pathogenesis
- Not well understood, although fetal movement may stimulate elongation of the cord - fetuses with decreased intrauterine movement tend to possess shorter cords, such as long standing oligohydramnios
Clinical features
- The following complications can be seen with short umbilical cords, mostly due to increased traction on the placenta during delivery:
- Placental abruption
- Cord rupture
- Cord hemorrhage or hematoma
- Other obstetric conditions include delayed second phase of labor, fetal distress, low Apgar scores and uterine inversion
- Developmental defects in the fetal abdominal wall can also be associated with a short umbilical cord
Case reports
- Pathological evaluation of four fetuses with limb body wall complex (Pathol Res Pract 2000;196:783)
- Infant, severely malformed with gastroschisis and a short umbilical cord, survived 62 minutes after birth (J Reprod Med 2000;52:529)
- Pathology of the umbilical cord in adrenal fusion syndrome (Pediatr Pathol Mol Med 2003;22:243)
Gross description
- Absolute / true length less than 35 cm; most accurately assessed at the time of delivery
- Umbilical cord length must be always included in the gross / macroscopic description; however, the diagnosis of short cord can only be made if the absolute length is known by the pathologist
Gross images
Images hosted on other servers:
Short umbilical cord sequence (SUCS)
Microscopic (histologic) description
- No significant histopathologic changes are associated with a short umbilical cord
Board review style question #1
All of the following are associated with short umbilical cords, except:
- A poorly understood etiology, although a genetic predisposition is possible
- Cord length is most accurately measured at the time of delivery
- Defined as an absolute cord length less than 35 cm
- Includes functionally shortened cords, such as with nuchal cords
- It increases the risk of traction phenomena on the placenta
Board review style answer #1
D. Includes functionally shortened cords, such as with nuchal cords
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Reference: Short umbilical cord
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Reference: Short umbilical cord
