E-ISSN: 2684-4230 ISSN: 2032-0418
Ultrasonographic evaluation of placental cord insertion at different gestational ages in low-risk singleton pregnancies: a predictive algorithm
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Original Papers
VOLUME: 8 ISSUE: 1
P: 3 - 7
March 2016

Ultrasonographic evaluation of placental cord insertion at different gestational ages in low-risk singleton pregnancies: a predictive algorithm

Facts Views Vis ObGyn 2016;8(1):3-7
F. Padula 1
A.S. Laganà 2
S.G. Vitale 2
L. Mangiafico 1
L. D’Emidio 1
P. Cignini 1
M. Giorlandino 1
F.A. Gulino 3
S. Capriglione 4
C. Giorlandino 1
1. Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, 00198 Rome (Italy)
2. Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98125 Messina (Italy)
3. Gynaecology and Obstetrics Section, Department of Medical Surgical Specialties, University of Catania, 95100 Catania (Italy)
4. Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, 00128 Rome (Italy)
No information available.
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Abstract

Objective

To evaluate the accuracy of ultrasound in visualizing placental cord insertion (PCI) at different gestational ages in order to recommend the most feasible period during pregnancy to identify it. Secondary aim was to propose a predictive algorithm for PCI visualization.

Methods

We performed a single-center, prospective cohort study. We enrolled patients with singleton low-risk pregnancies who underwent fetal ultrasound scan at different gestational ages. We excluded patients with body mass index of 30 Kg/m2 or more, uterine fibroids larger than 5 cm, high-risk pregnancies, fetal weight lower than 10° percentile or higher than 90° percentile, increased (“deep pocket” > 80 mm) or decreased (“deep pocket” < 20 mm) amniotic fluid.

Results

Among the 468 recruited patients, the visualization of PCI was not possible in 5.77% of the cases. Furthermore, we showed that PCI visualization was lower as the gestational age increased (p = 0.049) and more difficult in case of posterior placenta (p = 0.001).

Conclusions

PCI should be evaluated in the first trimester or as early as possible during the second trimester. Moreover, we propose a feasible model to predict the possibility of PCI visualization according to gestational age and uterine site of implantation.

Keywords:
Accuracy, fetal ultrasound, ultrasonography, placental cord insertion, predictive model, umbilical cord
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