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Marginal and Velamentous Cord Insertion
Roya Sohaey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Eccentric cord insertion
                • Battledore placenta
              • Definitions

                • Marginal placental cord insertion (MPCI): Umbilical cord (UC) inserts near placenta margin
                  • All branching vessels within placenta
                    • No submembranous vessels
                • Velamentous cord insertion (VCI): UC inserts on membranes
                  • Submembranous vessels branch and travel to placenta

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Ebbing C et al: Third stage of labor risks in velamentous and marginal cord insertion: a population-based study. Acta Obstet Gynecol Scand. 94(8):878-83, 2015
                                      2. Esakoff TF et al: Velamentous cord insertion: is it associated with adverse perinatal outcomes? J Matern Fetal Neonatal Med. 28(4):409-12, 2015
                                      3. Bowman ZS et al: Velamentous cord insertion with variable umbilical cord Doppler changes. J Ultrasound Med. 33(11):2039-41, 2014
                                      4. Bręborowicz GH et al: Prenatal diagnosis of vasa previa. J Matern Fetal Neonatal Med. 1-3, 2014
                                      5. Costa-Castro T et al: Velamentous cord insertion in monochorionic twins with or without twin-twin transfusion syndrome: Does it matter? Placenta. 34(11):1053-8, 2013
                                      6. Kuwata T et al: The 'mangrove sign' for velamentous umbilical cord insertion. Ultrasound Obstet Gynecol. 40(2):241-2, 2012
                                      7. De Paepe ME et al: Placental characteristics of selective birth weight discordance in diamniotic-monochorionic twin gestations. Placenta. 31(5):380-6, 2010
                                      8. Yampolsky M et al: Centrality of the umbilical cord insertion in a human placenta influences the placental efficiency. Placenta. 30(12):1058-64, 2009
                                      9. Sepulveda W et al: Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study. Ultrasound Obstet Gynecol. 21(6):564-9, 2003
                                      10. Liu CC et al: Sonographic prenatal diagnosis of marginal placental cord insertion: clinical importance. J Ultrasound Med. 21(6):627-32, 2002
                                      11. Di Salvo DN et al: Sonographic evaluation of the placental cord insertion site. AJR Am J Roentgenol. 170(5):1295-8, 1998
                                      12. Pretorius DH et al: Placental cord insertion visualization with prenatal ultrasonography. J Ultrasound Med. 15(8):585-93, 1996
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Eccentric cord insertion
                                                    • Battledore placenta
                                                  • Definitions

                                                    • Marginal placental cord insertion (MPCI): Umbilical cord (UC) inserts near placenta margin
                                                      • All branching vessels within placenta
                                                        • No submembranous vessels
                                                    • Velamentous cord insertion (VCI): UC inserts on membranes
                                                      • Submembranous vessels branch and travel to placenta

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Ebbing C et al: Third stage of labor risks in velamentous and marginal cord insertion: a population-based study. Acta Obstet Gynecol Scand. 94(8):878-83, 2015
                                                                          2. Esakoff TF et al: Velamentous cord insertion: is it associated with adverse perinatal outcomes? J Matern Fetal Neonatal Med. 28(4):409-12, 2015
                                                                          3. Bowman ZS et al: Velamentous cord insertion with variable umbilical cord Doppler changes. J Ultrasound Med. 33(11):2039-41, 2014
                                                                          4. Bręborowicz GH et al: Prenatal diagnosis of vasa previa. J Matern Fetal Neonatal Med. 1-3, 2014
                                                                          5. Costa-Castro T et al: Velamentous cord insertion in monochorionic twins with or without twin-twin transfusion syndrome: Does it matter? Placenta. 34(11):1053-8, 2013
                                                                          6. Kuwata T et al: The 'mangrove sign' for velamentous umbilical cord insertion. Ultrasound Obstet Gynecol. 40(2):241-2, 2012
                                                                          7. De Paepe ME et al: Placental characteristics of selective birth weight discordance in diamniotic-monochorionic twin gestations. Placenta. 31(5):380-6, 2010
                                                                          8. Yampolsky M et al: Centrality of the umbilical cord insertion in a human placenta influences the placental efficiency. Placenta. 30(12):1058-64, 2009
                                                                          9. Sepulveda W et al: Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study. Ultrasound Obstet Gynecol. 21(6):564-9, 2003
                                                                          10. Liu CC et al: Sonographic prenatal diagnosis of marginal placental cord insertion: clinical importance. J Ultrasound Med. 21(6):627-32, 2002
                                                                          11. Di Salvo DN et al: Sonographic evaluation of the placental cord insertion site. AJR Am J Roentgenol. 170(5):1295-8, 1998
                                                                          12. Pretorius DH et al: Placental cord insertion visualization with prenatal ultrasonography. J Ultrasound Med. 15(8):585-93, 1996