(Ultrasound Review) According to researchers at the University of California San Diego Medical Center, a diagnosis of marginal placental cord insertion (PCI) is not associated with growth retardation or preterm delivery.
"Abnormalities of placental cord insertion have been linked to a variety of poor obstetric outcomes," they reported. In particular, velamentous PCI has an association with poor fetal growth, fetal anomalies, preterm delivery and pregnancy complications, the authors noted.
"This study was designed to evaluate the impact of prenatally diagnosed marginal PCI on birth weight and duration of pregnancy," they wrote in the Journal of Ultrasound in Medicine.
Radiologists and perinatologists combined to retrospectively study 100 singleton pregnancies that were found to have a cord insertion 2cm or less from any placental edge. The PCI was routinely identified during the second trimester morphology scan. The relationship of PCI to adjacent placental edges and cord vessels as they entered the placenta was visualized. In addition, chorionic vessels were identified to avoid confusion with cord vessels.
In order to maximize sonographic specificity, a combination of color and power Doppler and grayscale was used to identify the PCI. Any low-lying, bipartite or succinturiate lobed placentas were scrutinized using transvaginal scanning to check for vasa previa.
The authors asserted that the PCI could be identified in all fetuses during the second trimester. Results demonstrated no significant association between marginal PCI and fetal growth restriction or premature delivery. Because of the retrospective nature of this study, the progression of marginal PCI to velamentous insertion was not evaluated. The authors recommend using a cutoff of 0.5cm from any adjacent placental edge for velamentous PCI and suggested that these pregnancies be carefully monitored sonographically for fetal growth.
Sonographic prenatal diagnosis of marginal placental cord insertionCC Liu et al
Department of radiology, University of California San Diego Medical, San Diego, CA
J Ultrasound Med 2002 June; 21: 627-632
By Ultrasound Review
July 24, 2002
Copyright © 2002 AuntMinnie.com
