Curettage is a risk factor for marginal umbilical cord insertion
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Abstract
Objective: To identify the risk factors for marginal cord insertion (MCI).
Material and Methods: This case-control study was carried out between 1st February and 30th June 2019. Singletons with and without MCI at delivery were recruited. Main variables analyzed included maternal age, parity, number of previous dilatation and curettage (D&C) or manual vacuum aspiration (MVA), time interval between each procedure and conception, cord insertion. Fisher’s exact test, t-test and logistic regression were used to compare data from both groups.
Results: We found 60 cases of MCI (4.1%). The significant (p < 0.05) risk factors for MCI were past-history of D&C (aOR 5.97, 95% CI 1.95-18.25) particularly when conception occurred ˂ 5 months after D&C (OR 10.5, 95% CI 1.36-81.05), fetal female sex (aOR 3.82, 95% CI 1.41-10.32), parity ≥ 4 (aOR 2.63, 95% CI 1.05-12.71) and past-history of MVA (aOR 2.06, 95% CI 1.23-8.76).
Conclusion: Women should be advised to conceive at least five months after D&C.
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Copyright (c) 2020 Nkwabong E, et al.
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Luo G, Redline RW. Peripheral insertion of umbilical cord. Pediatr Dev Pathol. 2013; 16: 399-404. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24020823
Brouillet S, Dufour A, Prot F, Feige JJ, Equy V, et al. Influence of the umbilical cord insertion site on the optimal individual birth weight achievement. Biomed Res Int. 2014; 43: 1-8.
Sun J, Wang L, Li Y. Clinical value of color doppler ultrasound in prenatal diagnosis of umbilical cord entry abnormalities. Pak J Med Sci. 2016; 32: 1414-1418. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28083036
Ebbing C, Kiserud T, Johnsen SL, Albrechtsen S, Rasmussen S. Prevalence, Risk Factors and Outcomes of Velamentous and Marginal Cord Insertions: A Population-Based Study of 634,741 Pregnancies. PLoS ONE. 2013; 8: e70380. PubMed: https://pubmed.ncbi.nlm.nih.gov/23936197/
Baergen RN. Umbilical Cord Pathology. Surg Pathol Clin. 2013; 6: 61-85.
Padula F, Laganà A, Vitale S, Mangiafico L, D'Emidio L, et al. Ultrasonographic evaluation of placental cord insertion at different gestational ages in low-risk singleton pregnancies: a predictive algorithm. Facts Views Vis ObGyn. 2016; 8: 3‑7. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096422/
Nkwabong E, Ndoumbe Mballo J, Dohbit JS. Risk factors for nuchal cord entanglement at delivery. Int J Gynecol Obstet. 2018; 141: 108–112. PubMed: https://pubmed.ncbi.nlm.nih.gov/29215708
Ismail KI, Hannigan A, O’Donoghue K, Cotter A. Abnormal placental cord insertion and adverse pregnancy outcomes: a systematic review and meta-analysis. Syst Rev. 2017; 6: 242. PubMed: https://pubmed.ncbi.nlm.nih.gov/29208042/
Nkwabong E, Njikam F, Kalla G. Outcome of pregnancies with marginal umbilical cord insertion. J Matern Fetal Neonatal Med. 2019: 17: 1-5. PubMed: https://pubmed.ncbi.nlm.nih.gov/31164018/
Li L, Shi J, Zhang QF, Yan J, Yan LY, et al. Effect of curettage and copper wire on rabbit endometrium: a novel rabbit model of endometrial mechanical injury. Chin Med J (Engl). 2011; 124: 1708-1713. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21740782
Sirimai K, Lertbunnaphong T, Malakorn K, Warnnissorn M. Comparison of Endometrial Pathology between Tissues Obtained from Manual Vacuum Aspiration and Sharp Metal Curettage in Women with Abnormal Uterine Bleeding. J Med Assoc Thai. 2016; 99: 111-118. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27249889
Choobun T, Khanuengkitkong S, Pinjaroen S. A comparative study of cost of care and duration of management for first-trimester abortion with manual vacuum aspiration (MVA) and sharp curettage. Arch Gynecol Obstet. 2012; 286: 1161-1164. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22684851
Azumaguchi A, Henmi H, Ohnishi H, Endo T, Saito T. Role of dilatation and curettage performed for spontaneous or induced abortion in the etiology of endometrial thinning. J Obstet Gynaecol Res. 2017; 43: 523-529. PubMed: https://pubmed.ncbi.nlm.nih.gov/28127830/
Ozgur K, Bulut H, Berkkanoglu M, Basegmez FO, Coetzee K. Six-month recovery needed after dilation and curettage (D and C) for reproductive outcomes in frozen embryo transfer. J Obstet Gynaecol. 2018; 38: 1150-1157. PubMed: