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Updated: Feb 13, 2026
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Published on: July 13, 2014
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Second trimester marginal cord insertion is associated with adverse perinatal outcomes
M Baraa Allaf1, Maria Andrikopoulou1, Natalie Crnosija2
1a NYU Winthrop Hospital , Nassau County, Long Island , NY , USA.
Summary
Visualizing placental cord insertion (PCI) is feasible in all second-trimester pregnancies. Marginal cord insertion (MCI) is linked to higher risks of preterm delivery and low birth weight.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Medical Imaging
Background:
- Placental cord insertion (PCI) site visualization is crucial for assessing fetal well-being.
- Marginal cord insertion (MCI) is a potential risk factor for adverse pregnancy outcomes.
- Second-trimester anatomical surveys offer an opportunity for early detection of PCI abnormalities.
Purpose of the Study:
- To assess the feasibility of visualizing PCI during the second-trimester fetal anatomical survey.
- To determine the association between MCI and preterm delivery (PTD) and low birth weight (LBW).
- To evaluate the link between MCI and adverse composite obstetrical and neonatal outcomes.
Main Methods:
- Prospective cohort study including 301 women with singleton pregnancies.
- PCI visualized using 2D grayscale and color Doppler between 18-22 weeks' gestation.
- MCI defined as cord insertion ≤2 cm from placental edge; statistical analyses included chi-squared, t-tests, Fisher's exact, and regression models.
Main Results:
- PCI visualization was feasible in 100% of cases.
- MCI incidence was 11.3%, associated with a history of PTD.
- MCI significantly correlated with increased likelihood of LBW (RR 4), PTD (RR 3.2), adverse obstetrical (RR 2.33), and neonatal outcomes (RR 2.46).
Conclusions:
- Second-trimester PCI evaluation is feasible in all pregnancies.
- MCI identified during the second trimester is a significant predictor of adverse pregnancy and neonatal outcomes.
- Early identification of MCI can inform clinical management and improve perinatal care.
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