Placental and Umbilical Cord Indices and Their Association with Fetal Distress in Hadiya Zone Public Hospitals, Southern Ethiopia: A Cross-Sectional Study

Abstract

Background: The placenta and umbilical cord have been considered as significant con-tributors to the perinatal outcome and have contributed to some degree to neonatal mortality. The placenta has a very crucial role in normal fetal development. After about four weeks of gestation, the only link of the fetus to the placenta is the umbilical cord. Very little is known about placental and umbilical indices in Ethiopia. This study was aimed to determine placental and umbilical cord indices and their association with fetal distress in Hadiya zone public hospitals, southern Ethiopia. Methods: This study included 249 placentae with the attached umbilical cord from normal singleton live birth with known gestational age. Bivariable and multivariable logistic regression was used, and variables with p < 0.25 in the bivariable analysis were entered into a multivariable logistic regression to identify the independent factors for the outcome variable. Odds ratios with 95% confidence were computed, and statistical significance was declared at p-value <0.05. Results: Three-fourth (75.9%) of diameter of studied placenta was in normal range and 18.1%, 6.0% below and above normal range, respectively. About one-third (32.9%) of umbilical cords were short, 61.8% normal, and 5.2% long. Newborns with thin placenta [AOR = 3.43; 95% CI: 1.25, 9.40], short cord length [AOR = 3.43; 95% CI: 1.66, 7.09] and long cord length [AOR = 7.55; 95% CI: 2.07, 27.53] were significantly associated with fetal distress. Conclusion: In this study, deviation of umbilical cord length from the normal range and placental thickness were significantly associated with fetal distress. In addition, fetal distress was also associated with gestation age and sex of the newborn.