Variations in Placental Attachment of Umbilical Cord

Reddy, V. Manikanta; Geetha, S.; Nim, Virender Kumar

doi:10.1016/s0003-2778(12)80002-5

Cited by 9 publications

(15 citation statements)

References 14 publications

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“…In our study, the attachment of umbilical cord was found to be normal (central/eccentric) in 87.14% placentae of uncomplicated pregnancies. This finding is consistent with those reported by earlier observers [19][20][21][22] in a manner that central and/ or eccentric cord insertions were the commonest type of attachment of the umbilical cord on placenta in uncomplicated pregnancies . Therefore, these types of cord attachments were considered as normal cord insertions.…”

Section: Discussionsupporting

confidence: 93%

Study of the Placental Attachment of Funiculus Umbilicalis in Normal and Pre-Eclamptic Pregnancies and Its Effects on Birth Weight

Jain¹,

Baweja²,

Jain³

2017

IJAR

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Section: Discussionsupporting

confidence: 93%

Study of the Placental Attachment of Funiculus Umbilicalis in Normal and Pre-Eclamptic Pregnancies and Its Effects on Birth Weight

Jain¹,

Baweja²,

Jain³

2017

IJAR

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“…4 In another study reported from India, Reddy et al based on ultrasonic observations and considering both central and eccentric insertions as normal concluded that 75% of placentae have normal insertions. 20 Similar observations have been made in other ultrasound based studies. [21][22][23][24] Yampolksy et al related non-centrality of cord insertion to placental efficiency, supporting the idea that placentae with displacement of the cord from the actual centre have poorer development of chorionic vasculature and therefore reduced efficiency.…”

Section: Discussionsupporting

confidence: 86%

“…In another study reported from India, Reddy et al . based on ultrasonic observations and considering both central and eccentric insertions as normal concluded that 75% of placentae have normal insertions 20 . Similar observations have been made in other ultrasound based studies 21 …”

Section: Discussionsupporting

confidence: 77%

Eccentric placentae have reduced surface area and are associated with lower birth weight in babies small for gestational age

Ravikumar

Crasta

Prabhu³

et al. 2018

J Dev Orig Health Dis

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Placental structure and function determine birth outcomes. Placental mass does not always correlate with fetal birth weight (BW) in uncomplicated pregnancies which raises the possibility of other variables such as placental shape and cord insertion being the determinants of placental efficiency. In total, 160 women with singleton pregnancy, recruited into a pregnancy cohort were studied. Placental weight (PW) was measured and other data were obtained from clinical records. Birth outcomes were classified as small for gestational age (SGA) and appropriate for gestational age (AGA) based on fetal gender, gestational age (GA) and BW. High-resolution images of the chorionic plate were recorded. The shape of the placenta and the insertion of the cord were measured using eccentricity index (EI) and cord centrality index (CCI). Only placentae with eccentrically inserted cords (n=136) were included. The mean BW and PW were 2942 (±435) g and 414 (±82) g with average GA of 38.6 weeks. The mean CCI and EI was 0.483 (±0.17) and 0.482 (±0.16). Neither of these correlated with placental efficiency. However, EI showed negative correlation with placental surface area and breadth. Upon sub-grouping the cohort into SGA (n=32) and AGA (n=104), the SGA babies with the highest EI (third tertile) had significantly lower BW than those with the least eccentric placentae (first tertile). Although eccentric-shaped placentae were present in both SGA and AGA groups, the effect on BW was observed only in the SGA group.

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“…Abnormalities in the development and site of the insertion of the umbilical cord can cause problems that have the potential to affect maternal and fetal health and wellbeing [3]. Marginal cord insertion (MCI), with an incidence ranging from 2 to 25% [5], is thought to be associated with different risk factors like bleeding in pregnancy, advanced maternal age, pregnancies conceived with the aid of artificial reproductive technology, maternal chronic disease, and drug abuse during pregnancy [6].…”

Section: Introductionmentioning

confidence: 99%

“…Normally umbilical cord inserts at the center or near the center (eccentric) of the placental disc tissue [ 3 ]. But sometimes it can attach to the periphery of the placental tissue (marginal insertion) or, otherwise the umbilical cord and its vessels inserted between the chorioamniotic membrane of the placenta rather than to the tissue [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Marginal cord insertion among singleton births at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Aragie

Oumer

2021

BMC Pregnancy Childbirth

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Background Umbilical cord may insert abnormally i.e. marginal insertion to a placenta which can cause different birth and perinatal complications. Despite the increased effort taken by different responsible bodies, the prevalence of birth and perinatal complications are still high, possibly due to anomalous cord insertion. So far, anomalous cord insertion lacks proper attention in different medical settings. Hence, the present study aims to assess the magnitude, risk factors, and adverse birth outcomes of marginal cord insertion among singleton births. Methods An institution-based cross-sectional study design was conducted. A systematic random sampling technique was used to select study participants. Data were collected by using a structured questionnaire and it was entered into epi-data version 3.1 then exported to SPSS version 20 for data cleansing and analysis. Bi-variable and multivariable logistic regressions were employed to identify risk factors and adverse outcomes associated with marginal cord insertions. Crude and adjusted odds ratio (P-value < 0.05) with a 95% confidence interval were calculated. Result The magnitude of marginal cord insertion was 6.4% (95% CI = 4.4–8.8%) in singleton pregnancies. Independent risk factors for marginal cord insertion were advanced maternal age (AOR = 2.24, 95% CI: 1.35–11.08), primiparity (AOR = 1.98, 95% CI: 1.37–8.69), maternal chronic hypertension (AOR = 3.07, 95% CI: 1.66–9.76), previous cesarean delivery (AOR = 2.51, 95% CI: 1.43–10.21), and use of intrauterine contraceptive device before pregnancy (AOR = 2.22, 95% CI: 1.36–12.30). Pregnancies complicated by marginal cord insertion are at higher risk to develop low birth weight (AOR = 2.89, 95% CI: 1.23–6.80), preterm birth (AOR = 4.00, 95% CI: 1.44–11.14), and emergency cesarean delivery (AOR = 3.68, 95% CI: 1.03–13.81). Conclusion and recommendation Marginal cord insertion is a mistreated potential risk for low birth weight, preterm birth, and emergency cesarean delivery. Routine screening of marginal cord insertion should be considered in pregnancies with advanced age, nulliparity, hypertensive disorder, history of cesarean section, and intrauterine contraceptive device usage before pregnancy.

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Variations in Placental Attachment of Umbilical Cord

Cited by 9 publications

References 14 publications

Study of the Placental Attachment of Funiculus Umbilicalis in Normal and Pre-Eclamptic Pregnancies and Its Effects on Birth Weight

Study of the Placental Attachment of Funiculus Umbilicalis in Normal and Pre-Eclamptic Pregnancies and Its Effects on Birth Weight

Eccentric placentae have reduced surface area and are associated with lower birth weight in babies small for gestational age

Marginal cord insertion among singleton births at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

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