Clinical implications of velamentous cord insertion in triplet gestations.
OBJECTIVE
The purpose of this study was to determine the incidence of velamentous cord insertion and to evaluate the association between velamentous cord insertion and small-for-gestational age infants in triplet gestations.


METHODS
We reviewed our computerized database to identify all cases of velamentous cord insertion in triplet gestations who were delivered at our institution from January 1995 through December 1999. Triplet gestations without velamentous cord insertion who were delivered during this period were used as control subjects. Birth weights and pregnancy outcomes were obtained from medical records. Data were analyzed with descriptive statistics, analysis of variance, and chi(2) with Fisher exact test, where appropriate.


RESULTS
Thirty-nine sets of triplets (117 infants) were delivered during the study period. Of these, 11 sets of triplets (28.2%) had a velamentous insertion of at least one umbilical cord. Infants with velamentous cord insertion were more likely to be small-for-gestational age than infants without velamentous cord insertion (33% vs 8%, P =.02). There were no significant differences in the rates of pregnancy complications between the two groups.


CONCLUSIONS
Velamentous cord insertion is found frequently in triplet gestations and is significantly associated with small-for-gestational age in triplet neonates.
Feldman
Deborah M
DM
Department of Obstetrics/Gynecology, Division of Maternal-Fetal Medicine, University of Connecticut Health Center, Framington, USA.
Borgida
Adam F
AF
Trymbulak
Walter P
WP
Barsoom
Michael J
MJ
Sanders
M Melinda
MM
Rodis
John F
JF
D002585:Cesarean Section; D005260:Female; D005313:Fetal Death; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D010929:Placentation; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D014310:Triplets; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000002:abnormalities*