{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:23:40Z","timestamp":1762917820273,"version":"3.37.3"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T00:00:00Z","timestamp":1503964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate perinatal outcomes in singleton and twin pregnancies with pathologically confirmed velamentous cord insertion without vasa previa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective case\u2010control study included all nonanomalous singleton and twin pregnancies with pathologically confirmed velamentous cord insertion delivered in a single institution between January 1, 2005, and July 1, 2015, and having an ultrasound examination by maternal\u2010fetal medicine. For each case, the next 2 consecutive deliveries matched for gestational age at delivery\u2009\u00b1\u20091 week and, in twins, amnionicity and chorionicity served as controls. Primary outcomes included surgical delivery for a nonreassuring intrapartum fetal heart rate tracing, umbilical arterial cord pH of less than 7.2, 5\u2010minute Apgar score of less than 7, birth weight below the 10th percentile, neonatal intensive care unit admission, fetal or neonatal death, and cord avulsion necessitating manual placental extraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Outcomes were available for 53 singletons with 103 matched controls and 33 twin pregnancies with 65 matched controls. In singletons, velamentous cord insertion was associated with cord pH of less than 7.2 (odds ratio [OR] 3.5; 95% confidence interval [CI], 1.1\u201311.2; <jats:italic>P<\/jats:italic>\u2009=\u2009.039), 5\u2010minute Apgar score of less than 7 (OR, 5.3; 95% CI, 0.99\u201328.1; <jats:italic>P<\/jats:italic>\u2009=\u2009.045), and cord avulsion requiring manual placental extraction (7.5% versus 0%; <jats:italic>P<\/jats:italic>\u2009=\u2009.012). Associations were suggested with increased surgical delivery for a nonreassuring intrapartum fetal heart rate tracing (OR, 2.4; 95% CI, 0.9\u20136.9; <jats:italic>P<\/jats:italic>\u2009=\u2009.14), birth weight below the 10th percentile (OR, 2.1; 95% CI, 0.8\u20135.9; <jats:italic>P<\/jats:italic>\u2009=\u2009.21), and fetal or neonatal death (3.8% versus 0%; <jats:italic>P<\/jats:italic>\u2009=\u2009.11). Velamentous cord insertions were also associated with placental abruption in singletons (7.5% versus 0%; <jats:italic>P<\/jats:italic>\u2009=\u2009.013). Among twins, velamentous cord insertion was associated with fetal or neonatal death (9.1% versus 0%; <jats:italic>P<\/jats:italic>\u2009=\u2009.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Isolated confirmed velamentous cord insertion is associated with adverse perinatal outcomes in singleton and twin gestations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.14357","type":"journal-article","created":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T15:34:19Z","timestamp":1504020859000},"page":"471-478","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Perinatal Outcomes Associated With Isolated Velamentous Cord Insertion in Singleton and Twin Pregnancies"],"prefix":"10.1002","volume":"37","author":[{"given":"Joshua A.","family":"Sinkin","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy Y.","family":"Craig","sequence":"additional","affiliation":[{"name":"Maine Medical Center Research Institute Scarborough Maine USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Pathology Maine Medical Center Portland Maine USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael G.","family":"Pinette","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4575-2308","authenticated-orcid":false,"given":"Joseph R.","family":"Wax","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3912-x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.08.021"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070380"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12666"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-994684"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13035"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.918098"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.132"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00339-8"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2005.03.028"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.170.5.9574605"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.12060426.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.33.2.189"},{"key":"e_1_2_6_15_1","unstructured":"American Institute of Ultrasound in Medicine.AIUM practice parameter for the performance of obstetric ultrasound examinations. 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