Objective: To determine the shortest umbilical cord length to permit spontaneous vaginal delivery Methods: This prospective observational study included 166 randomly chosen women, age \u2265 18 years, with no apparent antepartum complications who delivered spontaneously \u2265 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.
Wilson, Margaret; Gene LaMonica; Anne Fullilove; and William Rayburn. "Minimum Cord Length to allow Spontaneous Vaginal Delivery." (2008). http://digitalrepository.unm.edu/ume-research-papers/45