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Original Research

Accuracy of fetal anatomy survey in the diagnosis of velamentous cord insertion: a case–control study

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Pages 169-176 | Published online: 11 Mar 2019

Figures & data

Figure 1 (A) Color flow Doppler ultrasound showing velamentous umbilical cord inserting into fetal membranes, 2.19 cm off of placental disk for twin B in a monochorionic, diamniotic twin pregnancy identified at 20-week gestation. (B) Delivered monochorionic, diamniotic twin placenta at 30 weeks from same pregnancy as (A). There is a velamentous insertion of the umbilical cord for twin B (two clamps). Note the division of cord vessels within the fetal membranes and before they join the placental disk at multiple sites along the margin; insufficient imaging can confuse these vessels with a marginal cord insertion. The umbilical cord insertion site of twin A (one clamp) is inserted at the margin of the disk. This pregnancy was complicated by late-onset twin-to-twin transfusion syndrome with twin B, the donor, and twin A, the recipient.

Figure 1 (A) Color flow Doppler ultrasound showing velamentous umbilical cord inserting into fetal membranes, 2.19 cm off of placental disk for twin B in a monochorionic, diamniotic twin pregnancy identified at 20-week gestation. (B) Delivered monochorionic, diamniotic twin placenta at 30 weeks from same pregnancy as (A). There is a velamentous insertion of the umbilical cord for twin B (two clamps). Note the division of cord vessels within the fetal membranes and before they join the placental disk at multiple sites along the margin; insufficient imaging can confuse these vessels with a marginal cord insertion. The umbilical cord insertion site of twin A (one clamp) is inserted at the margin of the disk. This pregnancy was complicated by late-onset twin-to-twin transfusion syndrome with twin B, the donor, and twin A, the recipient.

Figure 2 Color flow Doppler ultrasound from singleton pregnancy during a routine fetal anatomy survey showing the PCI to be centrally located on the placental disk.

Abbreviation: PCI, placental cord insertion.
Figure 2 Color flow Doppler ultrasound from singleton pregnancy during a routine fetal anatomy survey showing the PCI to be centrally located on the placental disk.

Figure 3 Flow diagram of study inclusion.

Figure 3 Flow diagram of study inclusion.

Table 1 VCI vs normal PCI, pregnancy comparisons

Table 2 VCI vs normal PCI, neonatal and placental comparisons

Table 3 Characteristics of umbilical cord identification at the time of fetal anatomy survey

Table 4 Performance characteristics of fetal anatomy survey in the diagnosis of VCI