UMBILICAL CORD PATHOLOGY: WHAT LIES BEYOND ROUTINE ULTRASOUND EXAMINATION IN CASES OF FETAL CONGENITAL HEART DISEASE

The weight and condition of a newborn with a heart defect are important factors that determine the early and long-term results of cardiac surgery and are strictly dependent on intrauterine hemodynamics throughout the entire period of pregnancy. The pathologic structure of the umbilical cord associated with a high risk of perinatal hypoxia, growth retardation, and fetal death is detected in a significant proportion of fetal cardiovascular anomalies. The article presents a review of the literature on the modern capabilities of ultrasound in identifying umbilical cord pathology during pregnancy with fetal cardiac anomalies. This paper examines the incidence of various features of the umbilical cord structure in the general population and in cases of fetal heart defects. It also discusses the pathologic contribution of each of the anomalies to the hemodynamics of the uteroplacental system, and possible clinical manifestations that influence obstetric tactics. The article describes a range of clinically significant variants of abnormalities of the umbilical cord, including structural, attachment, length, and diameter abnormalities, as well as pathologic torsion and formation of knots. Conclusion: The necessity of multiparametric assessment of the umbilical cord structure during ultrasound examination in cases of fetal congenital heart disease is discussed. The results of such assessment will contribute to the development of individual tactics of pregnancy management, including the choice of the optimal time, method and term for delivery. The quality of life can be improved and life expectancy of the future patient can be increased. © A group of authors, 2024.