Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study
Article first published online: 9 MAY 2003
Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 21, Issue 6, pages 564–569, June 2003
How to Cite
Sepulveda, W., Rojas, I., Robert, J. A., Schnapp, C. and Alcalde, J. L. (2003), Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study. Ultrasound Obstet Gynecol, 21: 564–569. doi: 10.1002/uog.132
- Issue published online: 6 JUN 2003
- Article first published online: 9 MAY 2003
- Manuscript Accepted: 28 FEB 2003
- Hospital San Francisco de Asis de Quibdo, Choco, Colombia
- color Doppler ultrasound;
- prenatal diagnosis;
- three-dimensional (3D) ultrasound;
- umbilical cord;
- vasa previa;
- velamentous insertion
Velamentous insertion of the umbilical cord, with a reported incidence of 1% in singleton pregnancies, has been associated with several obstetric complications including fetal growth restriction, prematurity, congenital anomalies, low Apgar scores, fetal bleeding and retained placenta. The aim of this study was to determine the feasibility of identifying velamentous insertion of the umbilical cord during routine obstetric ultrasound.
This was a prospective, cross-sectional ultrasound study in 832 unselected second- and third-trimester singleton pregnancies. Color Doppler ultrasound was routinely performed to identify the placental cord insertion site. The role of three-dimensional (3D) ultrasound in evaluating the placental cord insertion site was also studied in a subset of 50 pregnancies from this population.
The placental cord insertion site was identified in 825/832 (99%) cases. Visualization was not achieved in seven third-trimester pregnancies with a posterior placenta. A velamentous insertion was suspected prenatally in eight cases, seven of which were confirmed after delivery as velamentous and one as markedly eccentric (battledore placenta). 3D ultrasound performed poorly at evaluating placental cord insertion site, being less efficient due to poor-quality resolution and far more time-consuming than the combined use of gray-scale and color Doppler ultrasound.
Velamentous insertion of the umbilical cord can reliably be detected prenatally by gray-scale and color Doppler ultrasound. 3D imaging had limited value in the evaluation of the placental cord insertion site in our subset of patients. Systematic assessment of the placental cord insertion site at routine obstetric ultrasound has the potential of identifying pregnancies with velamentous insertion and, therefore, those at risk for obstetric complications including vasa previa. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.