Umbilical Cord Circumference at Birth

Sir .—Recently, we saw a newborn who presented with swelling of the umbilical cord. The cord measured 70 mm at its attachment to the umbilicus (Figure). Examination on palpation revealed the presence of crepitus in the cord, and, interestingly, the abdominal roentgenogram revealed loops of bowel herniating through the defect in the umbilicus. The patient was immediately referred to a pediatric surgeon. Subsequently, we became concerned that if the cord had had been clamped near the base, it would have resulted in an intestinal obstruction. 1 This episode caused us to examine the following questions: (1) What is the normal size of the neonatal umbilical cord? (2) Do the newborn's measurements and weight have any relation ship to the size of the cord at birth? Review of the literature indicated that much is known about abnormalities of the cord, such as granulomas, infections, and hernias. However, we found no information about the normal cord circumference and the factors that correlate with it.