Premium
Second‐Trimester Ultrasound‐Measured Umbilical Cord Insertion–to–Placental Edge Distance: Determining an Outcome‐Based Threshold for Identifying Marginal Cord Insertions
Author(s) -
Wax Ian R.,
Cartin Angelina,
Craig Wendy Y.,
Pinette Michael G.,
Wax Joseph R.
Publication year - 2020
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.15113
Subject(s) - medicine , placental abruption , cord , odds ratio , obstetrics , umbilical cord , confidence interval , oligohydramnios , gestation , retrospective cohort study , fetus , gynecology , pregnancy , surgery , anatomy , genetics , biology
Objectives We sought to study potential diagnostic criteria for marginal placental cord insertions as determined by associations with obstetric outcomes. Methods This single‐center retrospective cohort investigation included singleton gestations delivering from January 1, 2012, to December 31, 2016, and having a standard or detailed fetal ultrasound examination from 18 weeks to 21 weeks 6 days. Cord insertion–to–placental edge distances were used to create a referent comparison group and 3 patient groups: greater than 3.0 cm (comparison); greater than 2.0 to 3.0 cm (group 1); greater than 1.0 to 2.0 cm (group 2); and 1.0 cm or less (group 3). The primary outcome consisted of any one of spontaneous delivery before 37 weeks, fetal growth restriction, oligohydramnios, placental abruption, or intrauterine fetal demise. Results The numbers of participants and mean distances ± SDs for the comparison group and groups 1 to 3, respectively, were 628 and 4.68 ± 1.17 cm, 106 and 2.52 ± 0.26 cm, 131 and 1.60 ± 0.29 cm, and 77 and 0.36 ± 0.37 cm, respectively. The primary outcome was significantly associated only with cord insertion–to–placental edge distances of 1.0 cm or less (adjusted odds ratio, 3.05; 95% confidence interval, 1.73–5.38). Conclusions Marginal cord insertions may be diagnosed when the cord insertion–to–placental edge distance is 1.0 cm or less.