Marginal cord insertion occurs when the umbilical cord is inserted into the margin of the placenta rather than the center.
This is an atypical condition that can occur during a pregnancy. The danger of a marginal cord insertion stems from the fact that blood flow to the fetus can be restricted, leading to potential growth challenges and an increased risk of birth injuries.
When managed correctly, however, most marginal cord insertions do not cause harm.
When Is Marginal Cord Insertion Diagnosed?
The umbilical cord is the fetus’ access to vital nutrients during the gestation period. This tube connecting parent and baby supplies the growing fetus with essential nutrition that supports life and allows brain and body development.
In typical cases, the umbilical cord attaches to the center of the placenta where the position is stable and nutrients can flow easily. In the case of marginal cord insertion, the umbilical cord attaches to a position not considered to be the center, two centimeters or fewer from the edge of the placenta.
A marginal cord insertion is usually detected and diagnosed between weeks 14 and 27—during the second trimester.
Because the mother does not often experience any symptoms associated with the condition, it is typically only detected during a routine ultrasound. A health care provider may notice abnormal umbilical cord placement, and follow-up tests using doppler technology can give a clearer picture of the blood flow to the fetus.
What Causes Marginal Cord Insertion?
There is no one, single cause of marginal cord insertion. There are a variety of factors that researchers have linked to increased risk of this abnormal condition.
Marginal cord insertion is more common in multiple births (such as twins or triplets). Up to one in four multiple pregnancies involve a marginal cord insertion, whereas single pregnancies (just one fetus) have an incidence rate as low as 2%.
Here are a few of the factors that can contribute to the likelihood of a marginal cord insertion:
- More than one fetus
- First-time pregnancy
- Diabetes or another chronic condition in the mother
- Drug use during the pregnancy
- Use of an intrauterine device (IUD) prior to pregnancy
- Pregnancy after age 35
- Pregnancy via artificial reproductive technology
What Risks Are Associated With Marginal Cord Insertion?
In most cases, a healthy pregnancy and birth are possible with a marginal placental cord insertion.
The major risk associated with marginal cord insertion is intrauterine growth restriction (IUGR). This happens when the fetus fails to obtain adequate nutrition due to restricted blood flow through the abnormally placed umbilical cord.
This can result in low birth weight and birth complications requiring a longer stay in the neonatal intensive care unit (NICU). To combat these risks, medical providers need to keep a close watch on the fetus’ growth rate and recommend treatments as required, such as C-section birth, steroid treatments (in rare cases), or additional post-partum nutritional care.
In extremely rare cases (about 1% of pregnancies), a marginal cord insertion can turn into a velamentous cord insertion.
Velamentous cord insertion is when the umbilical cord attaches to the membranes surrounding the placental wall instead of the actual placenta itself. If this happens, it is almost always within the third trimester, which makes close monitoring after a marginal cord insertion diagnosis especially important in the late stages of pregnancy.
How Is Marginal Cord Insertion Treated in a Pregnancy?
There is no treatment for marginal cord insertion.
It is the responsibility of the health care team to closely monitor the condition to ensure the patient and fetus are presenting normally and not exhibiting any troubling symptoms.
Close monitoring involves continually checking the baby’s vitals and the mother’s blood pressure and other metrics, and ensuring the fetus is developing at a normal rate of growth.
In some cases, a C-section may be recommended if there are foreseeable risks to the mother or baby. Careful, frequent watch is especially important when the fetus is not developing at an acceptable rate or is anticipated to have a low birth weight (less than 5 lbs. 8 oz.).
What Can I Do if My Child Suffered a Preventable Birth Injury Due to Marginal Cord Insertion?
Managing a healthy pregnancy in which marginal cord insertion is a factor requires medical diligence.
If your health team of obstetricians, nurses, midwives, and other medical professionals failed to provide you and your baby with the care your condition required—resulting in a preventable birth injury—it may be within your right to file a medical malpractice claim against the negligent party or parties.
Not all birth injuries are caused by medical malpractice. The labor and delivery process is inherently risky, no matter the conditions. Even under the best care, complications can occur.
But when your pregnancy is put at risk by a known health condition that is not appropriately diagnosed or managed, any resulting adverse outcomes may be the result of medical negligence.
At Shrager, Sachs, & Blanco, we have the specialized knowledge, resources, and connections within Philadelphia’s finest medical facilities to know when your birth injury could have (and should have) been prevented.
If you or your child experienced an injury because you received inadequate medical care, contact one of our birth injury attorneys. We can evaluate your case for free and advise you of your legal options.