Presentation
23 weeks gestation antenatal scan.
Patient Data
Right lateral placental of grade I maturation, located at the upper uterine segment, with right anterior and posterior parts location.
The umbilical cord shows normal 3-vessels appearance, with marginal insertion at its inferior pole of the posterior part. Normal umbilical and middle cerebral arteries Doppler for gestational age.
Case Discussion
This case features marginal cord insertion, an insertional variant of the umbilical cord, where the cord inserts within 2 cm from the placental margin. It can be associated with velamentous insertion as pregnancy progresses. Second-trimester marginal cord insertion can be associated with an increased likelihood for low birth weight, pre-term delivery, and adverse obstetrical and neonatal outcomes 1.
The last image features normal fetal tricuspid valve Doppler; E-wave = early ventricular filling and A-wave = atrial ventricular filling. E is smaller than A and the E/A ratio increases during pregnancy toward 1, to be inversed after birth.