Umbilical Cord and Major Fetal Vessels

Placental cord insertion visualization with prenatal ultrasonography.

“…Cord insertion visualization was possible at all gestational ages, although it was more difficult at later gestational ages. In conclusion, this study provides evidence that (1) ultrasonography (either gray scale or color Doppler) is useful in identifying normal, marginal, and velamentous cord insertion; (2) marginal cord insertion may evolve into velamentous cord insertion as pregnancy progresses; (3) in clinical practice the cord insertion site was visualized in just over half of the cases, and (4) prenatal identification of marginal and velamentous cord insertion potentially may be useful for planning obstetrical management. KEY WORDS: Placenta, ultrasonography; Umbilical cord; Velamentous cord.…”

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Color Doppler and gray scale sonography can be used prenatally to identify the location of the cord insertion into the placenta. The purposes of this paper were to (1) relate sonographic identification of placental cord insertion with placental pathology; (2) evaluate the possibility that a marginal cord insertion may evolve into a velamentous cord insertion; and (3) determine the frequency and factors affecting sonographic visualization of cord insertion. Our results show that the sonographic assessment of cord insertion correlated with the pathologic outcome in 83% (106 of 128) of singleton preganncies and at least one of the fetuses in 72% (8 of 11) of twin or triplet pregnancies.

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“…Prenatal sonography has the potential to identify normal, marginal, and velamentous CI. The purposes of this study were (1) to relate sonographic identification of placental CI with placental pathology; (2) to evaluate the possibility of marginal CI evolving into velamentous CI; and (3) to determine the frequency and factors affecting sanagraphic cr visualization.…”

Fused umbilical arteries: prenatal sonographic diagnosis and clinical significance.

“…Because a long segment of the cord was affected, the possibility of Hyrtl's anastomosis or physiologic fusion of the 2 umbilical arteries near the surface of the placenta, which may be a normal finding up to 3 cm from the placental insertion, was also ruled out. 7 Although the clinical significance of fused umbilical arteries is unclear, prenatal recognition of this condition could be important for several reasons. First, it represents a potential pitfall in the prenatal evaluation of the number of umbilical vessels, because the sole finding of a single artery in the cord does not necessarily imply that there is an umbilical artery missing, and the finding of normal intra-abdominal umbilical arteries on its own does not exclude SUA.…”

“…5 On the basis of the frequent finding of a vascular remnant at histologic examination of SUA cords, atrophy of a previously normal umbilical artery is thought to be the most probable cause of SUA in humans. 6,7 In this report we describe the prenatal diagnosis of fusion of the 2 umbilical arteries, resulting in only 1 artery for a long segment of the cord close to the placental insertion. This finding suggests that incomplete splitting of the primitive single artery may be, at least in some cases, another causative mechanism of SUA.…”