Absence of Wharton's jelly

Abstract

Absence of Wharton's jelly is a rare entity in which the umbilical cord vessels are
partially or completely separated from the umbilical cord. It is associated with
important fetal morbidity and mortality. Since its first report in 1961, only 12 cases
have been documented to date. We present two cases of this entity. The first one
occurred in a 21-year-old primigesta whose ultrasound study showed a nuchal
cord and oligohydramnios. A 2,620 g male neonate was born and died a few hours
later. The second case was in a 31-year-old multigesta with a history of HIV positivity
and abortion. She presented with a 375 g male fetus with left renal agenesis and
abdominal and cerebral hemorrhage. In these cases, a 9 cm and 7.8 cm segment of
umbilical artery was found, respectively, separated from the umbilical cord.