According to Shanklin, single umbilical artery is associated with higher incidence of marginal and velamentous
insertion of the umbilical cord and these anomalies have been found in 5.9% and 1.2% of all placentas respectively.
Once UCEA occurs, corresponding measures should be taken to solve the problem, for example, pregnant women, who are diagnosed as velamentous
umbilical cord entry, or combined with vasa previa through CDUS, can choose cesarean delivery.10 This research reviewed and analyzed the clinical data of sixty-four cases with confirmed UCEA by means of CDUS to study the clinical value of prenatal diagnosis of UCEA by means of CDUS and provide a reference for the effective prenatal diagnosis of UCEA.
type cord insertion to the chorio-amniotic membrane of placenta.
[The site of cord insertion was classified as velamentous
, eccentric (more than 2 cm from the placental edge), or marginal (less than 2 cm from the placental edge), and a discordant cord insertion was considered to be the combination of a velamentous
cord insertion in one fetus and an eccentric cord insertion in the other fetus.]
Marginal (<1 cm from the nearest margin) (27) and velamentous
insertions, but not peripheral (<3 cm from the nearest margin) (28) insertions, are associated with an increased risk of adverse pregnancy outcomes, including preterm delivery.
Cord insertion was marginal in eight, paracentral in three, and velamentous
In studies conducted by Benischke, Faye Petersen, Maulik and Salafia et al circumvallate placenta, circummarginate, velamentous
insertion of the cord and placenta previa were suggested as possible causes of IUGR.
Five entities--umbilical cord entanglement with monoamniotic twins, velamentous
cord insertion, funic presentation, oligohydramnios, and a noncoiled cord--are responsible for almost all cases.
, battle door, furcated insertion were not observed in the present study.
Some significant placental diagnoses can be suspected by a focused and careful gross examination of the placenta, requiring no histopathologic resources, for example, velamentous
cord insertion, retroplacental hematomas suggesting acute or chronic abruption, and placental infarcts (Tables 2 and 3).
Abnormal cord coiling probably acts synergistically with other factors in causing fetal morbidity and mortality, including thrombophilia, funisitis, meconium cord damage, nuchal cord, and velamentous