Evidence map›Paper›PMID 36971026›Full record

ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2023

Peripheral cord insertion is associated with adverse pregnancy outcome only when accompanied by clinically significant placental pathology.

D Stapleton, A Darmonkow, A Ravi Chandran, N Milligan, R Saghian, S Shinar, C L Whitehead, S R Hobson, L Serghides, C K Macgowan and 5 more

Open access · bronzeAbstract read
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In one paragraph

Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 3 countries.

D StapletonDepartment of Chemistry, Memorial University of Newfoundland, St John's, NL, Canada.
A DarmonkowDepartment of Chemistry, Memorial University of Newfoundland, St John's, NL, Canada.
A Ravi ChandranDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada.
N MilliganDivision of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
R SaghianMouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada.
S ShinarDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada.
C L WhiteheadDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada.ORCID 0000-0001-8267-1630
S R HobsonDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada.
L SerghidesToronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
C K MacgowanTranslational Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
J G SledMouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada.ORCID 0000-0002-4461-283X
J C KingdomDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada.
A A BaschatCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.ORCID 0000-0003-1927-2084
W T ParksDepartment of Pathology, Mount Sinai Hospital, Toronto, ON, Canada.
L S CahillDepartment of Chemistry, Memorial University of Newfoundland, St John's, NL, Canada.ORCID 0000-0003-1667-8564
Mount Sinai Hospital · CAMemorial University of Newfoundland · CAHospital for Sick Children · CAUniversity of Toronto · CAJohns Hopkins University · USUniversity Health Network · CA

Funding

Environmental factors in placental pathology: a new diagnostic method based on umbilical vessel wave mechanicsU01HD087177 · NICHD · HOSPITAL FOR SICK CHLDRN (TORONTO) · PI SLED, JOHN G · 2015 to 2015
$2.5M
NICHD NIH HHS U01 HD087177
6 · The paper itself

Abstract

objectiveTo examine the relationship between umbilical cord insertion site, placental pathology and adverse pregnancy outcome in a cohort of normal and complicated pregnancies.

methodsSonographic measurement of the cord insertion and detailed placental pathology were performed in 309 participants. Associations between cord insertion site, placental pathology and adverse pregnancy outcome (pre-eclampsia, preterm birth, small-for-gestational age) were examined.

resultsA total of 93 (30%) participants were identified by pathological examination to have a peripheral cord insertion site. Only 41 of the 93 (44%) peripheral cords were detected by prenatal ultrasound. Peripherally inserted cords were associated significantly (P < 0.0001) with diagnostic placental pathology (most commonly with maternal vascular malperfusion (MVM)); of which 85% had an adverse pregnancy outcome. In cases of isolated peripheral cords, without placental pathology, the incidence of adverse outcome was not statistically different when compared to those with central cord insertion and no placental pathology (31% vs 18%; P = 0.3). A peripheral cord with an abnormal umbilical artery (UA) pulsatility index (PI) corresponded to an adverse outcome in 96% of cases compared to 29% when the UA-PI was normal.

conclusionsThis study demonstrates that peripheral cord insertion is often part of the spectrum of findings of MVM disease and is associated with adverse pregnancy outcome. However, adverse outcome was uncommon when there was an isolated peripheral cord insertion and no placental pathology. Therefore, additional sonographic and biochemical features of MVM should be sought when a peripheral cord is observed. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

PlacentaPregnancy OutcomeUmbilical CordFemaleHumansInfant, NewbornPregnancyPremature BirthUmbilical ArteriesDoppler ultrasoundmaternal vascular malperfusionperipheral cord insertionplacental pathologypregnancy outcomeumbilical cord

Identifiers

PMID36971026
PMCPMC11348921
OpenAlexW4361007480

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.