A functional exchange shunt in the umbilical cord: the role of coiling in solute and heat transfer

Abstract: The umbilical cord plays a critical role in delivering nutrients and oxygen from the placenta to the fetus through the umbilical vein, while the two umbilical arteries carry deoxygenated blood with waste products back to the placenta. Although solute exchange in the placenta has been extensively studied, exchange within the cord tissue has not been investigated. Here, we explore the hypothesis that the coiled structure of the umbilical cord could strengthen diffusive coupling between the arteries and the vein, resulting in a functional shunt. We calculate the diffusion of solutes, such as oxygen, and heat in the umbilical cord to quantify how this shunt is affected by vascular configuration within the cord. We demonstrate that the shunt is enhanced by coiling and vessel proximity. Furthermore, our model predicts that typical vascular configurations of the human cord tend to minimise shunting, which could otherwise disrupt thermal regulation of the fetus. We also show that the exchange, amplified by coiling, can provide additional oxygen supply to the cord tissue surrounding the umbilical vessels.