From the Guidelines
Marginal cord insertion is associated with an increased risk of intrauterine growth restriction (IUGR), low birth weight, and preterm labor, which are the most common symptoms or complications affecting fetal development and pregnancy outcomes. The symptoms or complications associated with marginal cord insertion can be understood by considering the potential impact on fetal development and pregnancy outcomes.
Key Symptoms and Complications
- Intrauterine growth restriction (IUGR), where the baby doesn't grow at the expected rate
- Low birth weight
- Increased risk of preterm labor and delivery
- Vaginal bleeding during the second or third trimester due to the vulnerable position of the umbilical cord
- Abnormal fetal heart rate patterns detected during monitoring
- Placental abruption, where the placenta separates from the uterine wall before delivery These complications arise because marginal cord insertion means the umbilical cord attaches at the edge of the placenta rather than in the center, potentially compromising blood flow to the fetus, as noted in studies such as 1. Regular prenatal care with ultrasound monitoring is essential for pregnancies with marginal cord insertion to detect any of these complications early, especially considering the higher frequency of vasa previa and velamentous cord insertion in multiple gestations, which are associated with adverse pregnancy outcomes 1.
From the Research
Marginal Cord Insertion Symptoms
The most common symptoms of marginal cord insertion are not explicitly stated in the provided studies. However, the studies suggest that marginal cord insertion can be associated with various pregnancy complications, including:
- Low birth weight 2
- Preterm birth 2
- Emergency cesarean delivery 2
- Fetal intolerance to labor 3
- Gestational age at delivery 3
- Apgar scores at 1 and 5 minutes 3
- Birth weight 3
- Delivery complications 3
- Neonatal intensive care unit admission 3
- Small for gestational age (SGA) infants 4
- Abnormal placental morphology 4
- Retention of the placenta 4
- Cord-related adverse pregnancy outcomes 4
Risk Factors
The studies identify several risk factors associated with marginal cord insertion, including:
- Advanced maternal age 2
- Primiparity 2
- Maternal chronic hypertension 2
- Previous cesarean delivery 2
- Use of intrauterine contraceptive device before pregnancy 2
- Assisted reproductive technology 5
- Placenta previa 5
- Nulliparity 5
Diagnosis and Screening
The studies suggest that prenatal ultrasound can be used to diagnose marginal cord insertion 6, 3, 4. However, the accuracy of ultrasound in diagnosing marginal cord insertion and predicting adverse perinatal outcomes is still a topic of debate 3. Regular screening and monitoring of pregnancies with marginal cord insertion may be necessary to identify potential complications early on 4.