Sonographic diagnosis of funic presentation: implications for delivery

Persistent funic presentation resulting from marginal cord insertion into a low‐lying placenta

“…Therefore they concluded that funic presentation at a prenatal sonogram was not synonymous with cord prolapse in labor. While in selected cases conservative management with close monitoring and attempt at vaginal delivery have been advocated 4 , it is our opinion that in the presently described case funic presentation would not resolve, and cord complications in labor would have been likely due to the anatomical relationship between the internal cervical os and the marginal cord insertion. We recommend that in all cases of funic presentation the cord insertion into the placenta should be identified.…”

“…Prenatal diagnosis of funic presentation allows intervention by Cesarean delivery prior to labor or rupture of the membranes 1,2 . It should be noted, however, that funic presentation on sonography may resolve prior to the onset of labor 4 . A recent report described uneventful vaginal delivery of a patient who had a prenatally diagnosed funic presentation; there was no funic presentation identified at delivery 4 .…”

“…It should be noted, however, that funic presentation on sonography may resolve prior to the onset of labor 4 . A recent report described uneventful vaginal delivery of a patient who had a prenatally diagnosed funic presentation; there was no funic presentation identified at delivery 4 . A study by Ezra et al demonstrated that a significant proportion of cases of funic presentation diagnosed sonographically prenatally resolved spontaneously and did not result in cord prolapse in labor 3 .…”

“…This allows Cesarean delivery prior to the onset of labor, potentially avoiding cord prolapse, and therefore preventing the perinatal morbidity and mortality associated with this complication 1,2 . Recent studies, however, have suggested that funic presentation detected prenatally does not always result in cord prolapse in labor, since funic presentation not infrequently resolves spontaneously 3,4 . The challenge therefore is identifying which cases of prenatally diagnosed funic presentation are likely to persist until labor.…”

Cord presentation in labour: imminent risk of cord prolapse

“…Therefore, we agree with the majority of authors recommending caesarean section when funic presentation is found during labour. 4…”