Department of Obstetrics and Gynecology, Hôpitaux Iris Sud Etterbeek-Ixelles, Bruxelles, Belgium.
Department of Obstetrics and Gynecology, Hôpital Universitaire Saint Pierre, Bruxelles, Belgium.
J Matern Fetal Neonatal Med. 2021 Aug;34(16):2642-2648. doi: 10.1080/14767058.2019.1670797. Epub 2019 Sep 26.
The marginal and velamentous cord insertions complicate around 8% of pregnancies and are at higher risk of adverse perinatal outcomes. Their visualisation seems to decrease with advancing gestational age. Our aim was to analyse whether an umbilical cord insertion in the lower third of the uterus during the first trimester could predict abnormal cord insertions later in pregnancy.
This was a prospective multicentre study in two hospitals. During the first trimester, the cord insertions were inspected as well as their location (lower third of the uterus or not). Finally, all cord insertions were described at delivery.
During the study period the cord insertion was described in 1620 patients of which 87.7% had a normal cord insertion, 11.9% ( = 192) a low cord insertion, and in 3.8% the insertion could not be situated. We find that 4.7% of those who have a low-lying cord insertion versus 0.7% in the normal cord insertion group during the first trimester will have a velamentous cord insertion subsequently (OR = 6.67; 95% CI = 2.67-16.63).
The detection of a low lying umbilical cord insertion during the first-trimester ultrasound can help to predict an abnormal cord insertion at delivery particularly a velamentous cord insertion.
边缘性和帆状脐带附着在大约 8%的妊娠中较为复杂，并且发生不良围产儿结局的风险更高。随着妊娠周数的增加，它们的可视化程度似乎会降低。我们的目的是分析在妊娠早期脐带在子宫下段插入是否可以预测妊娠后期脐带附着异常。
这是在两家医院进行的前瞻性多中心研究。在妊娠早期，检查脐带插入位置（子宫下段或不在下段）。最后，在分娩时描述所有的脐带插入情况。
在研究期间，对 1620 名患者的脐带插入情况进行了描述，其中 87.7%的患者脐带插入正常，11.9%（=192）的患者脐带插入位置较低，3.8%的患者无法确定插入位置。我们发现，在第一孕期有低位脐带插入的患者中，有 4.7%会随后出现帆状脐带插入，而在正常脐带插入组中，这一比例为 0.7%（OR=6.67；95%CI=2.67-16.63）。
在早孕期超声检查中发现低位脐带插入可帮助预测分娩时的脐带附着异常，尤其是帆状脐带插入。
