What are the risk factors for marginal cord insertion?

Marginal cord insertion is more likely to occur if you're over the age of 35, pregnant with twins or triplets, or using assisted reproductive technologies like IVF. It may also be linked to first-time pregnancies.

What percentage of people have a marginal cord insertion?

Marginal cord insertion occurs in about 2 to 25 per cent of pregnancies. It’s more common in multiple pregnancies than in single-baby ones.

Marginal Cord Insertion: Causes, Risks, and Pregnancy Care

Pregnancy comes with many terms and tests you may not expect. One of them might be marginal cord insertion, also known as battledore placenta or battledore cord insertion. If you've come across this term in your ultrasound report or heard your doctor mention it, you’re probably wondering what it means and whether it’s something to worry about. In a typical pregnancy, the umbilical cord connects right at the centre of the placenta. That’s ideal because it allows for even blood flow and nutrient delivery. But in some cases, the cord attaches near the edge instead. This is what doctors call a marginal cord insertion. Don’t panic, it’s a common variation, and most pregnancies turn out just fine with proper care.

What is Marginal Cord Insertion?

The umbilical cord is like a lifeline for your baby, carrying oxygen and nutrients from the placenta to help them grow. Normally, the cord attaches right in the centre of the placenta. But in marginal cord insertion, the cord attaches to the edge of the placenta within about two centimetres of the margin. This off-centre attachment can sometimes make the connection less secure, which might affect how nutrients reach your baby. This condition is also known as battledore placenta. It gets the name battledore because the shape of this abnormal attachment resembles an old-fashioned paddle, where the cord connects at one end of the flat surface rather than the middle.

It’s also important to know that marginal cord insertion is different from a more serious condition called velamentous cord insertion. In this condition, the cord attaches to membranes outside the placenta, leaving blood vessels exposed. Battledore cord insertion is generally less risky and often just needs careful monitoring rather than urgent treatment. It’s fairly common, occurring in 2 to 25 per cent of pregnancies.

Why Does Marginal Cord Insertion Happen?

The exact cause isn’t fully understood, but it often happens due to the way the placenta forms early in pregnancy. When the embryo implants in the uterus, the placenta might not form in the ideal position. This can lead to the umbilical cord attaching off-centre instead of in the middle. Researchers can’t pinpoint one specific reason, but certain factors can increase the chances of this condition:

Carrying twins or triplets in the limited space in the uterus can increase the chances of battledore placenta.
Being over the age of 35.
Having your first pregnancy.
Living with chronic conditions like diabetes or high blood pressure.
Use of assisted reproductive technology, like in vitro fertilisation (IVF).
Using an intrauterine device (IUD) for contraception before pregnancy.
Smoking or substance misuse.

Having these factors doesn’t mean you’ll definitely have battledore cord insertion. Many people with these risks have perfectly normal cord attachments, and sometimes the condition happens without any clear cause.

What Are the Risks of Marginal Cord Insertion?

In most cases, it’s not a major concern, and many pregnancies with this condition go smoothly. However, there are some risks to be aware of:

Slow foetal growth: Because the cord’s attachment is less secure, it might reduce blood flow and lead to intrauterine growth restriction (IUGR). This means your baby may grow more slowly than expected and could have a low birth weight.
Foetal distress: Reduced blood or oxygen flow can cause changes in your baby’s heart rate or movement, especially during labour.
Preterm birth: There’s a slightly higher chance of delivering before 37 weeks.
Low Apgar score: This is a test done right after birth to check your baby’s heart rate, breathing, and other signs of health. A low score might mean your baby needs extra care.
Preeclampsia: This condition involves high blood pressure and can be more likely with marginal cord insertion.
Placental abruption: In rare cases, the placenta may separate from the uterine wall before delivery.
Miscarriage or stillbirth: These are very rare but possible outcomes if nutrient flow is severely affected.

Marginal cord insertion is usually not a cause for concern. It may slightly increase the risk of growth issues or delivery complications, but this is rare with good medical care. The most important thing is to attend your check-ups regularly and speak to your healthcare professional if you have any concerns.

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FAQs on Pregnancy and Umbilical Cord Issues: What Every Mother Should Know

What are the risk factors for marginal cord insertion?
Marginal cord insertion is more likely to occur if you're over the age of 35, pregnant with twins or triplets, or using assisted reproductive technologies like IVF. It may also be linked to first-time pregnancies.
What percentage of people have a marginal cord insertion?
Marginal cord insertion occurs in about 2 to 25 per cent of pregnancies. It’s more common in multiple pregnancies than in single-baby ones.