Purpose and Function of Wharton's Jelly
Wharton's jelly is a specialized mucoid connective tissue surrounding the umbilical cord vessels that primarily functions to protect these vessels from compression and torsion during fetal movement, ensuring continuous blood flow to the developing fetus. 1
Anatomical Structure and Composition
- Located within the umbilical cord, Wharton's jelly forms a protective gelatinous matrix around the two umbilical arteries and one umbilical vein
- Consists of mucopolysaccharides, collagen fibers, and mesenchymal stem cells
- Creates a porous, fluid-filled structure that acts as a cushioning system 1
Primary Functions
Mechanical Protection
- Prevents compression of umbilical vessels during fetal movement and maternal position changes
- Protects against cord twisting (torsion) that could compromise fetal blood supply
- Maintains vessel patency by preventing kinking or occlusion 1, 2
Structural Support
- Binds to umbilical vessels, maintaining their proper alignment
- Provides elasticity to accommodate fetal movements
- The thickness of Wharton's jelly is greater in the amniotic portion of the cord (closest to the fetus), providing enhanced protection where movement is most pronounced 2
Clinical Significance
Protective Role
- Absence of Wharton's jelly can lead to vessel compression or rupture, potentially resulting in fetal distress or death
- Cases where Wharton's jelly is absent at the abdominal insertion site require immediate attention and may necessitate surgical ligation 3
Association with Pregnancy Outcomes
- Decreased Wharton's jelly area is associated with:
- Low birth weight
- Small-for-gestational-age neonates
- Clinically significant placental pathology 4
- Wharton's jelly area scales proportionally with placental dimensions (width, length, surface area), suggesting it correlates with functional placental capacity 4
Therapeutic Potential
- Rich source of mesenchymal stem cells (WJ-MSCs) that express markers including CD105, CD73, CD90, Oct-4, Sox-2, and Nanog
- These stem cells have multilineage differentiation potential (osteogenic, adipogenic, chondrogenic)
- WJ-MSCs exhibit immunomodulatory properties and do not express MHC-II, making them promising candidates for allogeneic transplantation 5, 6
- Shows potential for tissue repair and regeneration applications, though most clinical applications remain investigational 6
Pathological Implications
- Alterations in Wharton's jelly have been observed in pregnancy complications such as:
- Gestational diabetes mellitus
- Preeclampsia
- Intrauterine growth restriction 4
- Abnormal cardiotocographic traces with no other clinical indications of fetal distress may warrant consideration of Wharton's jelly abnormalities 3
In summary, Wharton's jelly serves a critical protective function for umbilical vessels during fetal development, with its structure and quantity potentially reflecting overall placental health and function. Its rich stem cell content also makes it a promising source for regenerative medicine applications.