Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening

@article{BuchananHughes2020VelamentousCI,
  title={Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening},
  author={A. M. Buchanan-Hughes and Anna Bobrowska and Cristina Visintin and George Attilakos and John Marshall},
  journal={Systematic Reviews},
  year={2020},
  volume={9}
}
Background Velamentous cord insertion (VCI) is an umbilical cord attachment to the membranes surrounding the placenta instead of the central mass. VCI is strongly associated with vasa praevia (VP), where umbilical vessels lie in close proximity to the internal cervical os. VP leaves the vessels vulnerable to rupture, which can lead to fatal fetal exsanguination. Screening for VP using second-trimester transabdominal sonography (TAS) to detect VCI has been proposed. We conducted a rapid review… 

Clinical Significance of Velamentous Cord Insertion Prenatally Diagnosed in Twin Pregnancy

TLDR
There was no difference in the incidence of VCI in twins based on the chorionicity and VCI was not a risk factor for adverse perinatal outcomes excepting vasa previa and placenta accreta spectrum, which had a high incidence in twins with VCI.

Assisted Reproductive Technique and Abnormal Cord Insertion: A Systematic Review and Meta-Analysis

TLDR
ART may be correlated with an increased prevalence of abnormal cord insertion, however, most studies could not exclude confounding factors; thus, further studies are warranted to characterize ART as a risk factor for ACI.

Velamentous cord insertion ruptured during labour leading to acute fetal blood loss

TLDR
A 38-year-old nulliparous woman was admitted at 39 weeks in labour with sudden watery vaginal discharge and bleeding with a rapid drop in the fetal heart rate to 60 beats/min necessitated an emergency caesarean section.

Incidence and risk factors for velamentous umbilical cord insertion in singleton pregnancies after assisted reproductive technology

TLDR
Risk factors that might affect the incidence of velamentous umbilical cord insertion (VCI) in pregnancies after ART treatment are identified.

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

TLDR
This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.

Maternal exposure to fine particulate matter over the first trimester and umbilical cord insertion abnormalities.

TLDR
Exposure to total PM2.5 and some of its components over the first trimester increased the likelihood of abnormal cord insertion, which contributes to the occurrence of adverse birth outcomes.

ISUOG Practice Guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan

  • L. SalomonZ. Alfirevic W. Lee
  • Medicine
    Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
  • 2022
The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to

Placental abnormalities in congenital heart disease

TLDR
Current evidence relating placental health in CHD is reviewed, existing knowledge-gaps are appraised, promising new avenues to better understand the impact of placental function on fetal well-being are highlighted and emerging evidence from advanced quantitative and functional magnetic resonance imaging is reviewed.

Association of placental pathology and gross morphology with autism spectrum disorders

TLDR
Placental pathology and gross morphology do not appear to be associated with ASD, suggesting that any perinatal determinants of autism are not likely to be mediated through placental pathology.

References

SHOWING 1-10 OF 83 REFERENCES

Velamentous cord insertion: is it associated with adverse perinatal outcomes?*

  • T. EsakoffYvonne W. ChengJ. SnowdenS. TranB. ShafferA. Caughey
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2015
TLDR
VCI is associated with an increased risk of adverse perinatal outcomes such as intrauterine fetal demise, SGA, preterm delivery <37 weeks, need for manual removal of placenta and post-partum hemorrhage.

Velamentous cord insertion - an important obstetrical risk factor

TLDR
The attempt to visualize cord insertion in the mid-trimester as a routine part of obstetric sonography is recommended and the identification of velamentous cord insertion dictates the mode and timing of delivery and can improve fetal outcome.

Abnormal placental cord insertion and adverse pregnancy outcomes: a systematic review and meta-analysis

TLDR
The available evidence suggests an association between abnormal PCI and emergency cesarean delivery, however, the number of studies with comparable definitions of abnormal PCI was small, limiting the analysis of other adverse pregnancy outcomes, and further research is required.

Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case–control study

TLDR
The last pulsatility index value in the umbilical artery, before delivery, was significantly higher in pregnancies with VCI, which is of uncertain clinical value, and higher rates of (early) preterm delivery were found.

Prevalence, Risk Factors and Outcomes of Velamentous and Marginal Cord Insertions: A Population-Based Study of 634,741 Pregnancies

TLDR
The two conditions shared risk factors; twin gestation and pregnancies conceived with the aid of assisted reproductive technology were the most important, while bleeding in pregnancy, advanced maternal age, maternal chronic disease, female foetus and previous pregnancy with anomalous cord insertion were other risk factors.

Velamentous cord insertion and atypical variable decelerations with no accelerations

Abnormal Placental Cord Insertion and Adverse Pregnancy Outcomes: Results from a Prospective Cohort Study

TLDR
Digital imaging analysis using ImageJ software mapped the surface of the placenta and provided objective measurement of PCI site, and abnormal PCIs were significantly associated with an increased risk of small for gestational age and low birth weight.

Clinical Significance of Pregnancies Complicated by Velamentous Umbilical Cord Insertion Associated With Other Umbilical Cord/Placental Abnormalities

TLDR
VCI is associated with an increased risk of adverse perinatal outcomes irrespective of the presence of other umbilical cord/placental abnormalities.

Velamentous cord insertion into the lower third of the uterus is associated with intrapartum fetal heart rate abnormalities

To evaluate the accuracy of sonographic identification of the site of umbilical cord insertion (CI) at 18–20 weeks of gestation, to compare the sensitivities for detection of a velamentous cord
...