Absence of Wharton’s jelly: case report

Abstract

There are few reports in the literature of the absence of Wharton's Jelly. Here we report the seventh case in a primigravida, 22 years old, admitted after vaginal delivery of stillborn. The umbilical cord have a long segment with disruption of cord structures and the three blood vessels were completely separated from each other, with a minimum amount of Wharton's jelly remaining around each vessel. The absence of Wharton' jelly is associated with fetal distress, intrauterine growth restriction, and fetal death. Quantitative/qualitative studies of Wharton's jelly represent an open field of research for possible correlations with obstetric conditions and fetal deaths.

Absence of Wharton’s jelly: an association with feto-maternal morbidity

“…This structure gives elasticity to the umbilical cord, thus the main function of Wharton's jelly is the protection of the umbilical blood vessels by neutralizing the external pressure influence on blood flow between placenta and foetus. 6 If Wharton's jelly is poorly developed, or if the vessels remain unprotected, they become more prone to compression. 2,8 Wharton's jelly when exposed to temperature changes, collapses structures within the umbilical cord and thus provides a physiological clamping of the cord (an average of) 5 min after birth.…”

“…2,3 • 5 th case reported by Thomson and Hoo. 4 • 6 th case by Kulkarni et al 5 • 7 th case by Christiano et al 6 Here, it might be the 8th case report of absent Wharton's jelly. Patient was taken for caesarean section in emergency for fetal distress and unfavorable bishop score, to deliver a male child of 2.0 kg.…”

Absence of Wharton's jelly around an umbilical artery

“…1 The absence of Wharton's jelly is an exceptional situation with a few rare cases described in the literature. [2][3][4][5][6][7][8] This situation, while rare, can cause acute fetal distress and even perinatal death due to compression of unprotected vessels. We report a case of absence of Wharton's jelly around an umbilical artery.…”

Ausencia de gelatina de Wharton

“…En el caso de los fetos, 10 fueron de sexo masculino, en uno se desconoce, 8 (67%) presentaron mortalidad perinatal, 3 tuvieron bajo peso, 3 nacieron con malformaciones congénitas y uno fue producto de una fertilización in vitro.Los estudios sobre la gelatina de Wharton son escasos en la literatura. Representa un campo de investigación abierto para formular las correlaciones con problemas obstétricos, así como el establecimiento de mecanismos patógenos para algunos grupos de mortinatos(13) .…”