Cord insertion into the lower third of the uterus in the first trimester is associated with placental and umbilical cord abnormalities

Abstract

Objectives

Prediction of risk for vasa previa at 9–13 weeks' gestation

“…Because vasa previa is rare, to evaluate the usefulness of screening for vasa previa, a large number of subjects is required. In this paper we present a continuation of our previous study 15 with sufficient case numbers to demonstrate associations between low cord insertion at the first trimester and vasa previa.…”

“…Recently, ultrasonographic assessments have become popular to detect aneuploidy and other fetal anomalies in the first trimester. In a previous study, we demonstrated that an umbilical cord insertion site located on the lower third of the uterine wall at the first trimester was associated with various placental abnormalities at delivery, including a low‐lying placenta and velamentous cord insertion 14,15 . We concluded that the systematic identification of the cord insertion site during pregnancy while testing for other fetal abnormalities may be useful for the identification of vasa previa.…”

Placental Characteristics of Fetuses With Congenital Heart Disease

“…Our findings indicate that abnormal cord insertion onto the placenta is associated with an increased rate of CHD compared to centrally or paracentrally attached cords. Cord insertion is routinely evaluated during anatomy screening sonography and has been associated with placental and umbilical cord anomalies . The cardiac defects most strongly associated with abnormal cord insertion were conotruncal defects, left heart disease, and right heart disease.…”

Umbilical Cord Insertion to the Lower Uterine Segment Is a Risk Factor for Vasa Previa

“…The pathophysiology of Type II vasa previa may be explained by atrophy of the partial placenta around cervical os due to a poor blood supply. In our study, regardless of the location of placenta at delivery, low-lying placentas, velamentous cord insertion and placental abnormalities occurred frequently in cases in which cord insertion was noted to be in the lower uterine segment during the first trimester [11] . The cord insertion site is important for placental development.…”