Cord presentation

Last revised by Joshua Yap on 6 Jan 2023

A cord presentation (also known as a funic presentation or obligate cord presentation) is a variation in the fetal presentation where the umbilical cord points towards the internal cervical os or lower uterine segment.

It may be a transient phenomenon and is usually considered insignificant until ~32 weeks. It is concerning if it persists past that date, after which it is recommended that an underlying cause be sought and precautionary management implemented.

The estimated incidence is at ~4% of pregnancies.

Recognized associations include:

Color Doppler interrogation is extremely useful and shows cord between the fetal presenting part and the internal cervical os. However, unlike a vasa previa, the placental insertion is usually normal.

As the complicating umbilical cord prolapse can lead to catastrophic consequences, most advocate an elective cesarean section delivery for persistent cord presentation in the third trimester 3.

It can result in a higher rate of umbilical cord prolapse.

For the presence of umbilical cord vessels between the fetal presenting part and the internal cervical os on ultrasound consider:

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