Objectives We sought to study potential diagnostic criteria for marginal placental cord insertions as determined by associations with obstetric outcomes. Methods This single‐center retrospective cohort investigation included singleton gestations delivering from January 1, 2012, to December 31, 2016, and having a standard or detailed fetal ultrasound examination from 18 weeks to 21 weeks 6 days. Cord insertion–to–placental edge distances were used to create a referent comparison group and 3 patient groups: greater than 3.0 cm (comparison); greater than 2.0 to 3.0 cm (group 1); greater than 1.0 to 2.0 cm (group 2); and 1.0 cm or less (group 3). The primary outcome consisted of any one of spontaneous delivery before 37 weeks, fetal growth restriction, oligohydramnios, placental abruption, or intrauterine fetal demise. Results The numbers of participants and mean distances ± SDs for the comparison group and groups 1 to 3, respectively, were 628 and 4.68 ± 1.17 cm, 106 and 2.52 ± 0.26 cm, 131 and 1.60 ± 0.29 cm, and 77 and 0.36 ± 0.37 cm, respectively. The primary outcome was significantly associated only with cord insertion–to–placental edge distances of 1.0 cm or less (adjusted odds ratio, 3.05; 95% confidence interval, 1.73–5.38). Conclusions Marginal cord insertions may be diagnosed when the cord insertion–to–placental edge distance is 1.0 cm or less.

decreased AGPAR scores, and metabolic acidemia. The objective of this study was to assess the correlation between FLV in growth restricted (FGR) fetuses and neonatal PI assessed at birth. STUDY DESIGN: In this prospective cohort study of fetuses with an EFW <10 th percentile, the final ultrasound exam prior to delivery was used to obtain standard biometry, EFW, umbilical artery pulsatility index (UA PI), and 3D FLV acquisition. 3D FLV was completed by estimating the total thigh volume (TTV) along the femur using a 5-slice technique, as well as subcutaneous fat (SQ) and lean mass (LM; bone + muscle) volume assessments. Spearman's correlations were used to assess the relationship of the different thigh volumes with EFW, abdominal circumference (AC), and UA PI, with the neonatal Ponderal index. RESULTS: TTV, SQ, LM, AC, and EFW all significantly correlated with PI, while UA PI did not (Table 1). Patient characteristics of the 45 fetuses included in the cohort are found in Table 2. CONCLUSION: The correlation between the TTV, SQ, LM, EFW, and AC with UA PI support a strong link between fetal and neonatal measurements. This suggests that evaluating fetal thigh measurements may be a good index of the degree of "leanness" in a fetus, just as the PI is in the newborn. The lack of correlation between UA PI and neonatal Ponderal index is not surprising given UA PI is often not affected in late-FGR. Additional evaluation of the FLV and PI in the setting of FGR may improve the ability to distinguish between normal and pathologic FGR. (Funded by the Perelman IUGR Study)