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MARGINAL CORD
INSERTION - “BATTLEDORE
PLACENTA” |
DEFINITION |
The shortest distance between the cord insertion and placental edge is
within 2 cm (including 0.0 cm) (1). Described as a variant of normal umbilical
cord insertion (2).
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Case 1 |
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Case 2 |
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INCIDENCE |
- 7-9% of singleton pregnancies.
- 24-33% of twin pregnancies.
ULTRASOUND |
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Video clip of marginal insertion of
the umbilical cord
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COMPLICATIONS |
- IUGR (3).
- Preterm labor(4).
- Development of velamentous insertion as a result of "dynamic placentation" or trophotropism (the placenta may atrophy on one side and expand on the other side during the pregnancy) (1).
- Slightly decreased birth weight.
DIFFERENTIAL DIAGNOSIS |
Velamentous and marginal cord insertion may be difficult to differentiate as
the vessels in a velamentous cord lacking Wharton's jelly are smaller and
thinner than normal umbilical vessels making them more difficult to identify
using gray-scale imaging alone (5).
REFERENCES |
- Pretorius DH, Chau C, Poeltler DM et.al. Placental cord insertion visualization with prenatal ultrasonography. J Ultrasound Med 1996;15:585-593.
- Bjoro K Jr. Vascular anomalies of the umbilical cord. I. Obstetric implications. Early Hum Dev 1983;8:119.
- Rolschau J. The relationship between some disorders of the umbilical cord and intrauterine growth retardation. Acta Obstet Gynecol Scand 1978;72(Suppl):15.
- Brody S, Frenkel DA. Marginal insertion of the cord and premature labor. Am J Obstet Gynecol 1953;65:1305.
- Di Salvo DN, Benson CB, Laing FC et.al. Sonographic evaluation of the placental cord insertion site. AJR 1998;170:1295-1298.