title: [RISK FACTORS, COMPLICATIONS AND OUTCOMES OF PREGNANCIES WITH VELAMENTOUS CORD INSERTION].
abstract: BACKGROUND
  A velamentous cord insertion (VCI) describes a peripheral umbilical cord insertion to the placenta with blood vessels from the cord traversing fetal membranes before reaching the placental margin. These vessels remain unprotected and exposed to pressure and injury during pregnancy and labor.
  
  
  OBJECTIVE
  To determine the risk factors for VCI, and assess the risk for complications and adverse outcomes of pregnancies with VCI.
  
  
  METHODS
  A retrospective cohort study of women who gave birth at Soroka Medical Center between the years 1988 to 2011. We examined the risk factors, complications and adverse outcomes of pregnancies with VCI compared to those without VCI.
  
  
  RESULTS
  During the study period there were 246,488 births, of which 200 had VCI. Multifetal gestation (OR = 9.2), infertility treatments (OR = 4.3) and chronic hypertension (OR = 2.2 were found as independent risk factors for VCI. In addition, intrauterine growth retardation (OR = 4.3), polyhydramnion (OR = 2.3), fetal malformations (OR = 2.2), placental abruption (OR = 8.2), preterm birth (OR = 4.6), cesarean delivery (OR = 3.3) and low Apgar score (OR = 2.3) had significant correlation to VCI. Finally, the presence of VCI was found as an independent risk factor (OR = 4.07) for perinatal mortality.
  
  
  CONCLUSIONS
  Multifetal gestation and infertility treatments were the most important risk factors for VCI. These pregnancies had more complications and perinatal mortality. Given the results, we should consider close monitoring of pregnancies with the mentioned risk factors for the presence of VCI.
authors.forename: Gil
authors.initials: G
authors.lastname: Gutvirtz
authors.forename: Yael
authors.initials: Y
authors.lastname: Baumfeld
authors.forename: Iris
authors.initials: I
authors.lastname: Shoham
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D047928:Premature Birth / Q000453:epidemiology; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D014463:Ultrasonography; D014470:Umbilical Cord / Q000002:abnormalities / Q000000981:diagnostic imaging