Samantha de Los Reyes1, Janice Henderson2, Ahizechukwu C Eke2. 1. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
BACKGROUND: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. OBJECTIVES: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. SEARCH STRATEGY: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). SELECTION CRITERIA: Only studies involving VCI were included in the meta-analysis. DATA COLLECTION AND ANALYSIS: Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). MAIN RESULTS: There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). CONCLUSION: The presence of VCI was associated with adverse pregnancy outcomes.
BACKGROUND: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. OBJECTIVES: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. SEARCH STRATEGY: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). SELECTION CRITERIA: Only studies involving VCI were included in the meta-analysis. DATA COLLECTION AND ANALYSIS: Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). MAIN RESULTS: There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). CONCLUSION: The presence of VCI was associated with adverse pregnancy outcomes.
Authors: Tania F Esakoff; Yvonne W Cheng; Jonathan M Snowden; Susan H Tran; Brian L Shaffer; Aaron B Caughey Journal: J Matern Fetal Neonatal Med Date: 2014-05-27
Authors: Li Liu; Shefali Oza; Daniel Hogan; Jamie Perin; Igor Rudan; Joy E Lawn; Simon Cousens; Colin Mathers; Robert E Black Journal: Lancet Date: 2014-09-30 Impact factor: 79.321