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Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case–control study

Archives of Gynecology and Obstetrics volume 293, pages 975–981 (2016)Cite this article

Abstract

Purpose

Velamentous umbilical cord insertion (VCI) is associated with adverse pregnancy outcomes. Literature lacks data on Doppler. We aimed to evaluate obstetric outcomes and results of uterine and umbilical artery Doppler flowmetry associated with VCI.

Materials and methods

In a retrospective case–control study, 108 singleton pregnancies with VCI were age- and body mass index-matched to 108 singleton pregnancies without VCI. The main outcome parameters were obstetric outcome, pregnancy-related complications, uterine artery flowmetry at the second-trimester screening, and umbilical artery flowmetry before delivery. Statistical analysis was accomplished using Pearson’s Chi-square test or Fisher’s exact test, and the Mann–Whitney U test, where appropriate.

Results

Pregnancies with VCI revealed a significantly higher PI in the umbilical artery during the last measurement before delivery (1.00 ± 0.25 vs. 0.90 ± 0.10; p = 0.001). Gestational age at this measurement did not differ between the groups. Fetal malformations and intrauterine fetal death were more common in pregnancies with VCI (12.7 vs. 0 %; p < 0.001, and 6.5 vs. 0 %; p = 0.014, respectively). Patients with VCI delivered significantly earlier (36.2 ± 4.5 vs. 38.4 ± 2.6; p < 0.001).

Conclusion

Higher rates of (early) preterm delivery were found in pregnancies with VCI. Fetuses with VCI also suffered from malformations and IUFD more frequently. The last pulsatility index value in the umbilical artery, before delivery, was significantly higher in pregnancies with VCI, which is of uncertain clinical value.

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Affiliations

  1. Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria

    Gülen Yerlikaya, Sophie Pils, Stephanie Springer, Kinga Chalubinski & Johannes Ott

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  1. Gülen Yerlikaya
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  2. Sophie Pils
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  3. Stephanie Springer
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  4. Kinga Chalubinski
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  5. Johannes Ott
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Correspondence to Johannes Ott.

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Yerlikaya, G., Pils, S., Springer, S. et al. Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case–control study. Arch Gynecol Obstet 293, 975–981 (2016). https://doi.org/10.1007/s00404-015-3912-x

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  • DOI: https://doi.org/10.1007/s00404-015-3912-x

Keywords

  • Velamentous cord insertion
  • Vasa previa
  • Umbilical artery
  • Doppler
  • Pulsatility index