The umbilical cord is a vital connection during pregnancy, linking the developing fetus to the placenta and supporting the baby’s growth. While it typically attaches centrally, variations can occur. Understanding these variations, such as when the cord connects to the side of the placenta, provides insight into potential implications.
The Umbilical Cord’s Vital Role and Typical Placement
The umbilical cord is the primary conduit for exchange between the pregnant individual and the fetus. It transports oxygen and nutrient-rich blood to the developing baby and carries deoxygenated blood and waste products away. This structure usually contains two umbilical arteries and one umbilical vein, surrounded by protective Wharton’s jelly. In most pregnancies, the umbilical cord inserts directly into the center or near the center of the placenta. This central attachment allows for the most efficient flow of nutrients and oxygen to the fetus.
Understanding Marginal Cord Insertion
Marginal cord insertion, also known as battledore placenta, occurs when the umbilical cord attaches to the edge of the placenta, within two centimeters of its margin. This condition is observed in approximately 7% to 9% of singleton pregnancies. It differs from velamentous cord insertion, a more concerning variation. In velamentous insertion, the umbilical cord vessels separate and travel unprotected through the membranes before reaching the placenta, making them more vulnerable to compression or rupture. With marginal insertion, the cord still attaches to the placental tissue at the periphery, generally posing fewer risks than velamentous insertion.
Implications and Management During Pregnancy
While many pregnancies with marginal cord insertion proceed without complications, the condition can be associated with certain considerations. These include a slightly increased risk of fetal growth restriction, where the baby may be smaller than expected for gestational age, and a lower birth weight. Marginal cord insertion has also been linked to an increased chance of preterm birth.
Diagnosis typically occurs during a routine prenatal ultrasound, often in the second trimester. Healthcare providers use ultrasound, sometimes with Doppler features, to pinpoint the exact attachment site of the umbilical cord to the placenta. Since there is no medical intervention to change the cord’s position, management focuses on close monitoring of the pregnancy. This may involve more frequent ultrasounds to track fetal growth and assess overall well-being. Additional tests, such as biophysical profiles or non-stress tests, might be used to evaluate the baby’s health.
While complications like placental abruption or excessive bleeding during labor are possible, most individuals with marginal cord insertion experience healthy pregnancies and deliver healthy babies. Vaginal delivery is often possible, though a cesarean section may be considered if specific complications arise during labor.