The cord that is inserted into the membranes some distance from the edge of placenta is-
A. Velamentous insertion of cord
B. Battledore insertion of cord
C. Succenturiate placenta
D. Circumvallate placenta
Correct Answer: A. Velamentous insertion of cord
Explanation
The correct answer is Velamentous insertion of the umbilical cord.
Explanation
In velamentous insertion, the umbilical cord does not attach directly to the placental disc. Instead:
- The cord is inserted into the fetal membranes (amnion and chorion)
- This insertion occurs some distance away from the edge of the placenta
- The umbilical blood vessels then travel through the membranes without Wharton’s jelly before reaching the placenta
Why this is important
- These exposed vessels are fragile and unprotected
- They can be easily compressed or ruptured, especially during labor
- It is associated with complications such as vasa previa, fetal hemorrhage, and fetal distress
Differentiation from similar conditions
- Battledore insertion → cord attached at the margin (edge) of the placenta
- Central insertion → cord attached at the center of the placenta
- Velamentous insertion → cord attached to the membranes away from placental edge ✅
📌 Hence, the cord inserted into the membranes some distance from the placental edge is called velamentous insertion.
Other Options Details
Here is a clear explanation of all the given options related to placental and umbilical cord abnormalities:
A. Velamentous insertion of cord
- The umbilical cord does not attach directly to the placental disc.
- Instead, it inserts into the fetal membranes (amnion and chorion).
- The umbilical blood vessels then travel unprotected (without Wharton’s jelly) before reaching the placenta.
- Risks:
- Vessel rupture
- Fetal hemorrhage
- Vasa previa
- Fetal growth restriction
B. Battledore insertion of cord
- The umbilical cord is attached to the margin (edge) of the placenta, resembling a badminton racket (battledore).
- Blood vessels are still protected by Wharton’s jelly.
- Usually causes no major complications, but may be associated with:
- Reduced placental efficiency
- Intrauterine growth restriction (IUGR)
C. Succenturiate placenta
- The placenta has one or more accessory (extra) lobes separate from the main placental disc.
- These lobes are connected by blood vessels running through the membranes.
- Risks:
- Retained placental tissue after delivery
- Postpartum hemorrhage
- Vasa previa (if vessels cross cervical os)
D. Circumvallate placenta
- An extrachorial placenta where the chorionic plate is smaller than the basal plate.
- The placental margins are rolled up, forming a thick ring.
- Associated complications:
- Antepartum hemorrhage
- Placental abruption
- Preterm labor
- Fetal growth restriction
Summary Table
Condition Key Feature Velamentous insertion Cord inserts into membranes Battledore insertion Cord attached to placental margin Succenturiate placenta Accessory placental lobe present Circumvallate placenta Rolled placental edges
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Writer: Vandita Singh, Lucknow (GS India Nursing Group