Second-Trimester Ultrasound-Measured Umbilical Cord Insertion-to-Placental Edge Distance: Determining an...

Area of Science:

• Perinatal medicine
• Fetal imaging
• Obstetric diagnostics

Background:

• Marginal placental cord insertion is a variation in umbilical cord attachment.
• Accurate diagnostic criteria for marginal cord insertion are needed to assess associated obstetric risks.

Purpose of the Study:

• To investigate potential diagnostic criteria for marginal placental cord insertions.
• To determine the association between cord insertion-to-placental edge distance and adverse obstetric outcomes.

Main Methods:

• Retrospective cohort study of singleton gestations with mid-trimester fetal ultrasound.
• Categorization of cord insertion-to-placental edge distances into groups: >3.0 cm (comparison), >2.0-3.0 cm (group 1), >1.0-2.0 cm (group 2), and ≤1.0 cm (group 3).
• Primary outcome included preterm delivery, fetal growth restriction, oligohydramnios, placental abruption, or intrauterine fetal demise.

Main Results:

• A total of 628 participants were in the comparison group, with mean distances of 4.68 ± 1.17 cm.
• Groups 1, 2, and 3 included 106, 131, and 77 participants, respectively, with mean distances of 2.52 ± 0.26 cm, 1.60 ± 0.29 cm, and 0.36 ± 0.37 cm.
• Distances of 1.0 cm or less were significantly associated with the primary adverse outcome (adjusted odds ratio, 3.05; 95% CI, 1.73-5.38).

Conclusions:

• A cord insertion-to-placental edge distance of 1.0 cm or less can be used to diagnose marginal placental cord insertions.
• This diagnostic criterion is linked to a significantly increased risk of adverse obstetric events.