Outcome of pregnancies with marginal umbilical cord insertion

Abstract

Purpose

To evaluate the outcome of labor in cases of marginal umbilical cord insertions.

Material and methods

This case-control study was carried out between December 1st, 2017 and April 30th, 2018. All singletons with marginal cord insertion (MCI) and three new-borns without MCI were recruited. The main variables studied included gestational age at delivery, occurrence of preeclampsia, intrapartum haemorrhage, mode of delivery, cord insertion, cord length, birth and placenta weights, presence of nuchal cord, Apgar score and admission of the new-born into the neonatal intensive care unit (NICU). Data from both groups were compared. Fisher exact test, t-test and logistic regression were used for comparison. p < .05 was considered statistically significant.

Results

Our prevalence of MCI was 7.2% (85/1181). MCI was significantly associated with pre-eclampsia (aOR 2.94, 95%CI 1.14–7.59), placenta abruption (OR 33.68, 95%CI 9.80–115.76), nuchal cord entanglement (aOR 3.07, 95%CI 1.69–5.59), low birth weight (aOR 3.15, 95%CI 1.05–9.45) and transfer of the newborn to the NICU (OR 4.72, 95%CI 2.46–9.04).

Conclusions

MCI is associated with increased maternal, fetal and neonatal adverse morbidities. Therefore, pregnancy with MCI should be well followed up. Moreover, the delivery should be conducted in settings where rapid intensive neonatal care can be offered.

Keywords:

• Marginal umbilical cord insertion; maternal outcome; fetal outcome; immediate neonatal outcome; transfer of the newborn to the neonatal intensive care unit

Disclosure statement

The authors report no declaration of interest.