Marginal Insertion Of Umbilical Cord Research Articles

Anomalous Marginal Insertion of Umbilical Cord in Placentas of COVID-19-Affected Pregnant Mothers: A Cross-Sectional Study.

Aim Study the effect of coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the placenta and in turn study its effects on pregnancy and newborn outcomes. Methods In this cross-sectional study, which was conducted in the term pregnant women who underwent delivery, their placentas were collected after delivery along with the mothers' blood and cord blood. Results Among the 212 pregnant women recruited, the prevalence of marginal cord insertion (MCI) in the placentas after delivery, was found to be 23% (n=48). Among these 48 cases (n=48) with MCI, 58.33% (n=28) were COVID-19 positive. The placentas with MCI had significantly lower minimum placental circumference (probability value/p value=0.04)and significantly longer umbilical cord (p-value=0.05). COVID-19 antibodies transfer from themother to the umbilical cord (C/M antibodies ratio) was observed to be lower, albeit insignificantly. Both the weight of newborns (p value=0.03) and their COVID-19 antibodies levels (p-value=0.05) were observed to be significantly lower in the MCI group. Univariate analysis shows that a body mass index (BMI) ≥ 23 of the mothers was significantly associated with abnormal MCI. Conclusion The prevalence of MCI was observed to be high in COVID-19-affected mothers in our study. MCI was associated with lower placental size, newborn weight, lesser transfer of COVID-19 antibodies from the mother to the fetus across the umbilical cord, and lower antibody levels in the cord blood when compared to maternal blood.

A Study Evaluating Correlation between Umbilical Cord Attachment on Placenta in Normotensive and Hypertensive Pregnant Females and its Effects on Fetus

Introduction: Well nourished newborn is a reflection of adequate placental function.The umbilical cordthat connects fetus and placenta can attach itself to placenta at different placenta.The incidence of central,eccentric, marginal and velamentous cord insertion is 18%,73%, 7% and 1-2%, respectively. This insertiontype significantly influences fetal growth and pregnancy outcomes.Methodology: This study was conducted in Department of Anatomy of SBKS MIRC, Vadodara. This was acomparative study between normotensive and hypertensive group in which 500 subjects, in each group wereincluded. Insertion of umbilical cord on placentawas determined and fetal growth and outcome with type ofinsertion were correlated.Results: The two groups were comparable in terms of demographics.Higher proportion of those inhypertensive group had marginal insertion of umbilical cord (23.40%) as compared to 2.90% in normotensivegroup. Mean systolic (150.10±7.51mmHg) as well as diastolic blood pressure (91.23±4.00mmHg) washigher in those with marginal insertion of placenta. Mean fetal birth weight and APGAR score at birth and 5minute and proportion of fetus reaching full term, live births were low in those in those in the hypertensivegroup especially in those with marginal insertion of placenta.Conclusion: Thus it can be concluded that abnormal attachment of umbilical cord on placenta has significantimpact on fetal growth and influences the outcomes of pregnancy directly and indirectly

Study of placental morphometric anatomy in mothers with gestational diabetes mellitus and inৎluence of gestational diabetes mellitus on the fetal weight

The placenta is an organ which is an indicator of maternal and fetal disorders. Gestational Diabetes mellitus complicates 2-5% of all pregnancy. Therefore our work was an analysis of changes in placental morphometric anatomy in mothers of gestational diabetes mellitus and the influence of gestational diabetes mellitus on the fetal weight. Sixty-two placentas of full-term pregnancy collected from labour room/operation theatre of Gynaecology and obstetrics, department of government medical college and super facility hospital Azamgarh, Uttar Pradesh. Out of sixty-two placentas, 31 are from mothers with no known history of preexisting gestational diabetes mellitus cases as controls and 31 collected from mothers with gestational diabetes mellitus. We found mean placental weight, mean placental area, mean placental volume, mean no of cotyledons significantly more in placentas of gestational diabetic mothers. Mean fetal weight of gestational diabetic mothers were more in comparison with controls. Mean transverse diameter of placentas of the diabetic mothers were more than mean transverse diameter of placentas of the non-diabetic mothers, statistically significant. Mean longitudinal diameter also more in placentas of diabetic mothers, not statistically significant. Mean thickness at the centre more in placentas of diabetic mothers, statistically significant. Mean thickness mid-way between centre and margin and mean thickness at margin more in diabetic placentas, not statistically significant. Gestational diabetic mothers had more round-shaped placentas. Marginal insertion of umbilical cord presents more in placentas of gestational diabetic mothers.

Curettage is a risk factor for marginal umbilical cord insertion

Curettage is a risk factor for marginal umbilical cord insertion

Effects of marginal umbilical cord insertion on the prognosis of fetus

Effects of marginal umbilical cord insertion on the prognosis of fetus

Outcome of pregnancies with marginal umbilical cord insertion

Purpose To evaluate the outcome of labor in cases of marginal umbilical cord insertions. Material and methods This case-control study was carried out between December 1st, 2017 and April 30th, 2018. All singletons with marginal cord insertion (MCI) and three new-borns without MCI were recruited. The main variables studied included gestational age at delivery, occurrence of preeclampsia, intrapartum haemorrhage, mode of delivery, cord insertion, cord length, birth and placenta weights, presence of nuchal cord, Apgar score and admission of the new-born into the neonatal intensive care unit (NICU). Data from both groups were compared. Fisher exact test, t-test and logistic regression were used for comparison. p < .05 was considered statistically significant. Results Our prevalence of MCI was 7.2% (85/1181). MCI was significantly associated with pre-eclampsia (aOR 2.94, 95%CI 1.14–7.59), placenta abruption (OR 33.68, 95%CI 9.80–115.76), nuchal cord entanglement (aOR 3.07, 95%CI 1.69–5.59), low birth weight (aOR 3.15, 95%CI 1.05–9.45) and transfer of the newborn to the NICU (OR 4.72, 95%CI 2.46–9.04). Conclusions MCI is associated with increased maternal, fetal and neonatal adverse morbidities. Therefore, pregnancy with MCI should be well followed up. Moreover, the delivery should be conducted in settings where rapid intensive neonatal care can be offered.

Insertion of Umbilical Cord on Placenta in Hypertensive Mother

Background: Hypertensive disorders in pregnancy are responsible for significant amount of maternal and perinatal morbidity and mortality. This study was designed to see the association of umbilical cord insretion on placenta in hypertensive mothers. Objective: This purpose of the present stufdy was to find out the site of umbilical cord insertion on placenta in pregnancy associated with hypertension and to correlate it with the weight of the placenta and the condition of the newborn. Methodology: This descriptive cross-sectional study was conducted at the Department of Anatomy, Rajshahi Medical College and Department of Obstetrics &amp; Gynaecology at Rajshahi Medical College &amp; Hospital, Bangladesh. Placental weight, diameter, thickness, insertion site of umbilical cord, insertion percentage of the cord and weight of newborn were noted. The site of cord insertion was detected and insertion percentage was calculated with the help of d/r x 100. Results: A total 130 cases were selected for the study, 30 from normal, 33 from mild, 34 from moderate and 33 from severe hypertensive group respectively. The study demonstrated that mild to severe hypertension had smaller placentas with the tendency of deviation of umbilical cord towards the margin for insertion. Newborns of such mothers had low birth weight mostly; few of them had birth asphyxia.Conclusion: This study has been established that the marginal insertion of umbilical cord on placenta is associated with hypertension and severity of hypertension deviates the insertion site towards the margin.Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 89-93

Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities

Objective: Birth asphyxia and hypoxic ischemic encephalopathy (HIE) of the newborn remain serious complications. We present a study investigating if placental or umbilical cord abnormalities in newborns at term are associated with HIE.Materials and methods: A prospective cohort study of the placenta and umbilical cord of infants treated with hypothermia (HT) due to hypoxic brain injury and follow-up at 12 months of age has been carried out. The study population included 41 infants treated for HT whose placentas were submitted for histopathological analysis. Main outcome measures were infant development at 12 months, classified as normal, cerebral palsy, or death. A healthy group of 100 infants without HIE and normal follow-up at 12 months of age were used as controls.Results: A velamentous or marginal umbilical cord insertion and histological abruption was associated with the risk of severe HIE, OR = 5.63, p = 0.006, respectively, OR = 20.3, p = 0.01 (multiple-logistic regression). Velamentous or marginal umbilical cord insertion was found in 39% among HIE cases compared to 7% in controls.Conclusions: Placental and umbilical cord abnormalities have a profound association with HIE. A prompt examination of the placentas of newborns suffering from asphyxia can provide important information on the pathogenesis behind the incident and contribute to make a better early prognosis.

OP30.09: Perinatal outcome and timing of delivery in type II monochorionic twins with sIUGR and marginal umbilical cord insertion

OP30.09: Perinatal outcome and timing of delivery in type II monochorionic twins with sIUGR and marginal umbilical cord insertion

OP31.04: Marginal umbilical cord insertion in sIUGR monochorionic twins does not correlate with TTTS and optimal timing of delivery avoid adverse perinatal outcome

between IUGR and SGA (P = 0.003), IUGR and AGA (P < 0.0001), SGA and AGA P < 0.003). IUGR showed a significant difference in perinatal morbidity between SGA and AGA (P < 0.0001). Conclusions: The present study highlights that aIMT is higher in IUGR compared to SGA vs. AGA and in SGA vs. AGA fetuses, highlighting that Doppler velocimetry and birth weight are predictors of aorta stiffness. Moreover, to our knowledge this is the first study considering aIMT in twin pregnancies, which may be considered a model of study to consider early cardiovascular markers in the same environment.

Risk Factors for Postpartum Hemorrhage: Can We Explain the Recent Temporal Increase?

ObjectiveTo assess risk factors for postpartum hemorrhage (PPH) and the extent to which changes in those risk factors may explain the rising incidence of PPH recently reported from industrialized countries. MethodsWe carried out a hospital-based cohort study of 103 726 consecutive deliveries from January 1, 1978, to January 31, 2007, from the computerized medical records of a tertiary-care university maternity hospital in Montreal. We examined adjusted odds ratios for any PPH (estimated blood loss > 500 mL for vaginal deliveries, > 1000 mL for Caesarean sections), severe PPH (estimated blood loss ≥ 1500 mL), and PPH accompanied by blood transfusion and/or hysterectomy. ResultsMajor independent risk factors for PPH included primiparity, prior Caesarean section, placenta previa or low-lying placenta, marginal umbilical cord insertion in the placenta, transverse lie, labour induction and augmentation, uterine or cervical trauma at delivery, gestational age < 32 weeks, and birth weight ≥ 4500 g. An overall increase in rate of PPH over the study period (OR 1.029; 95% CI 1. 024 to 1.034 per year) disappeared (OR 0.995; 95% CI 0.988 to 1.001 per year) after inclusion of maternal age, parity, prior Caesarean section, labour induction and augmentation, placenta previa or low-lying placenta, and abnormal placenta, with most of the reduction attributable to rises in previous Caesarean section and labour augmentation. ConclusionLabour induction, augmentation of labour, and prior Caesarean section are significantly associated with the risk of PPH, and their increase over the study period largely explains the observed rise in PPH.

A data mining analysis of pathological findings in 11259 placentas

To systematically review the pathological findings in placentas, we identified a data set of 11259 cases from 1996 to 2007 in our database. The diagnoses, along with available clinical information, were extracted from the reports by text mining, and parsed into a relational database. The associations among various epidemiologic and pathologic features with clinical outcomes were examined by data mining analysis. The maternal age at delivery ranged from 12 to 49 years (mean 24). Eight diagnostic categories included 26 items, such as no significant pathological change (55%), infarct (16%), villitis (15%), and accelerated maturation (9%). Statistically significant findings (p&lt;0.0001) included: increased maternal age since 2001; increased percentage of cases with pathological findings in women ≥30 years; prematurity associated with age &gt; 26 years, obliterative fetal vasculopathy, inflammation, infarct, thrombosis, marginal umbilical cord insertion, and previous preterm birth; accelerated maturation associated with inflammation, obliterative fetal vasculopathy, marginal umbilical cord insertion, but negatively correlated with calcification. Plotted by maternal age versus gestational age, inflammatory processes and circulatory problems clustered in distinct areas. In conclusion, this study showed that data mining is a valuable approach to discover hidden patterns in large clinical data sets.