Relationship Between Anatomic Features of the Placenta, the Type of Abnormal Placental Cord Insertion and Adverse Pregnancy Outcomes in Singleton Pregnancies: A Prospective Observational Study

Abstract

Introduction: This study aimed to evaluate the potential value of placental anatomic features and various types of normal and abnormal cord insertion types in predicting adverse maternal-fetal outcomes in singleton pregnancies. We also tried to assess the association between these outcomes and various types of placental cord insertion. Method: This prospective observational study was performed on singleton pregnancies. For each patient placental features including diameter, thickness, type of cord insertion, and the shortest distance between the cord insertion point and placental edge were recorded. The relationship between these factors and the development of multiple adverse pregnancy outcomes including preterm labor, intrauterine fetal death (IUFD), and the rate of neonatal intensive care unit (NICU) admissions were evaluated and reported. Results: Overall 308 patients were enrolled in the study. Smoker mothers had significantly smaller placentas ( P-value = .008), and those with lower diameter placentas were more likely to suffer from IUFD ( P-value = .0001). Shorter placental cord insertion distances led to more episodes of preterm labor ( P-value = .057). Eccentric-type placental cord insertion was significantly associated with the development of preeclampsia ( P-value = .006). Discussion: Abnormalities in placental diameter and cord insertion can lead to significant maternal-fetal complications including preterm labor, IUFD, and preeclampsia.