Risk Factors And Perinatal Outcomes Of Velamentous Cord Insertion

ObjectiveWe performed a retrospective analysis to investigate the risk factors of velamentous cord insertion(VCI)and the impact on perinatal outcomes,in addition to explore the methods of diagnosis and the appropriate treatments in perinatal period of VCI.MethodsThe clinical data of 178 pregnant women with velamentous cord insertion from Women’s Hospital,School of Medicine,Zhejiang University were analyzed retrospectively.Meanwhile,178 pregnant women without VCI in the same period were randomly enrolled as the control group.Chi-square test was conducted to compare the difference of outcomes between two groups.ResultsThe incidences of multiple pregnancy,placenta previa,assisted reproductive technologies and cesarean section in the VCI group were significantly higher than those in the control group(P<0.05).Moreover,adverse perinatal outcomes of fetus,such as preterm delivery,lower Apgar score,more fetal intrauterine death,smaller figures for gestational age and more fetal malformation,were observed in the VCI group(P<0.05).ConclusionsAt present,color Doppler ultrasonography is an crucial method for prenatal diagnosis of VCI.We indicate that multiple pregnancy,placenta previa and assisted reproductive technologies are dependent risk factors of velamentous cord insertion,which can lead to adverse perinatal outcomes.In addition to improve the positive detection rate of VCI,obstetricians should pay attention to pregnant women in such situation.Once the diagnosis is confirmed,measures should be taken to evaluate the fetal safety during prenatal period,and individualized delivery manner should be chosen to improve perinatal outcomes.