Clinical value of color doppler ultrasound in prenatal diagnosis of umbilical cord entry abnormity

Sun, Jiandong; Wang, Li; Li, Yinghui

doi:10.12669/pjms.325.10518

Cited by 9 publications

(14 citation statements)

References 9 publications

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“…To what degree cord abnormalities may be detected in utero is unclear. Ultrasound is a good method for detection of abnormal cord insertion, although a larger proportion of abnormal cord insertions were correctly identified during the second trimester compared to the third trimester [ 41 , 42 ]. Magnetic resonance imaging (MRI) has also been tested to measure umbilical cord length.…”

Section: Discussionmentioning

confidence: 99%

Maternal obesity and stillbirth at term; placental pathology—A case control study

et al. 2021

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Objective The aim was to explore the potential role of the placenta for the risk of stillbirth at term in pregnancies of obese women. Methods This was a case-control study comparing placental findings from term stillbirths with placental findings from live born infants. Cases were singleton term stillbirths to normal weight or obese women, identified in the Stockholm stillbirth database, n = 264 and n = 87, respectively. Controls were term singletons born alive to normal weight or obese women, delivered between 2002–2005 and between 2018–2019. Placentas were compared between women with stillborn and live-born infants, using logistic regression analyses. Results A long and hyper coiled cord, cord thrombosis and velamentous cord insertion were stronger risk factors for stillbirth in obese women compared to normal weight women. When these variables were adjusted for in the logistic regression analysis, also adjusted for potential confounders, the odds ratio for stillbirth in obese women decreased from 1.89 (CI 1.24–2.89) to 1.63 (CI 1.04–2.56). Conclusion Approximately one fourth of the effect of obesity on the risk of stillbirth in term pregnancies is explained by umbilical cord associated pathology.

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Section: Discussionmentioning

confidence: 99%

Maternal obesity and stillbirth at term; placental pathology—A case control study

et al. 2021

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“…The variables recorded on a pre-established questionnaire included maternal age at delivery, parity, tobacco or alcohol consumption, number of previous dilatation and curettage (D&C) or manual vacuum aspiration (MVA), time interval between D&C or MVA and conception, past history of CS, chronic hypertension (blood pressure ≥ 140/90 mmHg before pregnancy or before 20 weeks' gestation or both), overt diabetes (fasting blood sugar ˃ 125 mg/dl), gestational age at delivery (con irmed by an ultrasound scan performed before 20 weeks of gestation), mode of delivery, cord insertion (MCI was de ined in this survey as the insertion of the umbilical cord with its external margin at less than 2 cm from that of the placenta [2,3].…”

Section: Methodsmentioning

confidence: 99%

“…Marginal cord insertion (MCI) is de ined as the insertion of the umbilical cord within a distance of ˂ 3 cm from the placental margins [1]. For others, the cord is said to be marginally inserted when the distance between the external margin of the umbilical cord and that of the placenta is less than 2 cm [2,3]. The prevalence of MCI varies between 6.3% and 7% in singleton pregnancies [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

Curettage is a risk factor for marginal umbilical cord insertion

Nkwabong¹,

Mbeleck²,

Tumasang³

2020

Clin J Obstet Gynecol

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Objective: To identify the risk factors for marginal cord insertion (MCI). Material and Methods: This case-control study was carried out between 1 st February and 30 th June 2019. Singletons with and without MCI at delivery were recruited. Main variables analyzed included maternal age, parity, number of previous dilatation and curettage (D&C) or manual vacuum aspiration (MVA), time interval between each procedure and conception, cord insertion. Fisher's exact test, t-test and logistic regression were used to compare data from both groups. Results: We found 60 cases of MCI (4.1%). The signifi cant (p < 0.05) risk factors for MCI were past-history of D&C (aOR 5.97, 95% CI 1.95-18.25) particularly when conception occurred ˂ 5 months after D&C (OR 10.5, 95% CI 1.36-81.05), fetal female sex (aOR 3.82, 95% CI 1.41-10.32), parity ≥ 4 (aOR 2.63, 95% CI 1.05-12.71) and past-history of MVA (aOR 2.06, 95% CI 1.23-8.76). Conclusion: Women should be advised to conceive at least fi ve months after D&C.

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“…The defining element in describing marginal insertion of the umbilical cord ( Figure 3 ) is for the cord insertion to be located within 2 or 3 cm of the placental edge [ 77 , 78 , 79 ]. Although many authors consider that there is no increased risk, complications such as intrauterine growth restriction, preeclampsia, preterm labor and progression to velamentous cord insertion were described [ 32 , 78 ].…”

Section: Ultrasonographic Aspects Of Pathological Classification Of Ucamentioning

confidence: 99%

Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology

et al. 2022

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Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies.

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Clinical value of color doppler ultrasound in prenatal diagnosis of umbilical cord entry abnormity

Cited by 9 publications

References 9 publications

Maternal obesity and stillbirth at term; placental pathology—A case control study

Maternal obesity and stillbirth at term; placental pathology—A case control study

Curettage is a risk factor for marginal umbilical cord insertion

Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology

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