The Umbilic Cord Attachment Anomality and Discordant Growth of Fetus in Twin Pregnancy
Abstract
In the modern world, the reduction of maternal and perinatal morbidity and mortality remain as the main problems. One of the causes of perinatal complications is the pathology of the umbilical cord. The purpose of the study was to determine the relationship between abnormal cord attachment and fetal discordant growth in twin pregnancies. In 73 (46.8%) cases were found marginal attachment of the umbilical cord, in 26 (14%) cases were sheathing attachment and normal attachment occurred in 87 (46.8%) cases. The relationship between abnormal attachment of the umbilical cord with the type of placentation was determined. In women with MCh and DCh type, marginal attachment was detected in 28 (41.2%) and 45 (38.1%), sheath attachment in 14 (20.6%) and 12 (10.2%) cases, respectively. The relationship between the discrepancy between body weight at birth and the type of umbilical cord attachment was determined. There was a high percentage of discordance by birth weight >25% in 23.6% in pregnancies with sheath attachment of the umbilical cord. Determination of chorionism, amniogenecity and detection of placental abnormalities are key issues for adequate management of multiple pregnancies.
References
Costa-Castro T, Zhao DP, Lipa M, Haak MC et al. Velamentous cord insertion in dichorionic and monochorionic twin pregnancies Does it make a difference? // Placenta. -2016. -№42. -87-92. doi: 10.1016/j.placenta.2016.04.007. PMID: 27238718.
Santana DS, Silveira C, Costa ML, Souza RT, Surita FG et al. Perinatal outcomes in twin pregnancies complicated by maternal morbidity: evidence from the WHO Multicountry Survey on Maternal and Newborn Health. //BMC Pregnancy Childbirth. -2018. -18(1). –P.449. doi:10.1186/s12884-018-2082-9.
Kogan Ya.E. Pathology of the umbilical cord and its role in perinatal complications // Practical medicine. - 2016. - No. 1. S. -93.
Ebbing C, Kiserud T, Johnsen SL, Albrechtsen S, Rasmussen S. Prevalence, Risk Factors and Outcomes of Velamentous and Marginal Cord Insertions: A Population-Based Study of 634,741 Pregnancies// PLoS ONE. -2013. –V. 8. -№7. e70380. https://doi.org/10.1371/journal.pone.0070380
Kalafat E., B. Thilaganathan, A. Papageorghiou, A. et al. Significance of placental cord insertion site in twin pregnancy. //Ultrasound Obstet Gynecol. – 2018. -№52. –P. 378 – 384. DOI:10.1002/uog.18914
Radzinsky V.E., Fuksa A.M., Obstetrics textbook. Moscow. -2016 -P. 54-57
Kostyukov K.V. Prenatal assessment of fetal growth in multiple pregnancies depending on the type of placentation // Journal of Obstetrics and Gynecology. -2020. -#2. -FROM. 88-96.
Cambiaso O, Zhao DP, Abasolo JI, Aiello HA et al. Discordance of cord insertions as a predictor of discordant fetal growth in monochorionic twins. //Placenta. -2016 Nov. -№47. -P. 81-85. doi: 10.1016/j.placenta.2016.09.009. PMID: 27780543.
Van Grambezen A, Steenhaut P, Van Grambezen B, Debiève F, Bernard P, Hubinont C. The Umbilical Cord and Complications of Twin Gestations. //Maternal Fetal Med. -2022. –V.4 (4). –P.276–285. doi: 10.1097/FM9.0000000000000173.
Hubinont C, Lewi L, Bernard P, Marbaix E, Debiève F, Jauniaux E. Anomalies of the placenta and umbilical cord in twin gestations//Am J Obstet Gynecol. -2015. -213. –P.91-S102. doi: 10.1016/j.ajog.2015.06.054. PMID: 26428508.
Nikitina I, Boychuk A, Kalashnik N, et al. Immunomorphological features of the placenta in multiple pregnancies // Georgian Med News. -2016. - №255. –P.12-6. PMID: 27441529.
Voicu NL, Berceanu S, Paitici Ş et all. Clinical and Morphological Study of Single and Twin Pregnancies Placenta. //Curr Health Sci J. -2020. №46(1). – P. 44-55. doi: 10.12865/CHSJ.46.01.07.
