Battledore Placenta

and Velamentous
Insertion of the
Cord
 Battledore
• or Marginal Cord Insertion
Placenta
• It is a condition in which the umbilical cord is
inserted at or near the placental margin rather
than in the center.
• The cord can be inserted as close to
2cm from the edge of the placenta.
• Complications associated with battledore
placenta are preterm labor, fetal distress, and
intrauterine growth restriction.
Management of Battledore Placenta
• via ultrasound or routine antenatal imaging
evaluation
• In this case a planned cesarean section should
be considered to reduce the risk of fetal
hemorrhage during labor.
Velamentous Insertion
of the Cord
• The cord, instead of entering the placenta
directly, it separates into small vessels that
reach the placenta by spreading cross a fold
of amnion
• The cord is inserted to chorioamniotic
membrane
• Because of the lack of protection from
Wharton's jelly, these vessels are prone to
compression and rupture.
• Velamentous cord insertion have higher
incidence in early pregnancy and
spontaneous abortions.
Complications:
• Complicated with VCI are at greater risk for
adverse perinatal outcome (fetal growth
restriction, preterm labor, placental abruption,
Low apgar scores, Preeclampsia
Management:
• Ultrasound every 4-6 weeks
• Do regular non-stress tests on the fetus. A non-
stress test monitors the fetus’s heart rate and
movement.
• Schedule a C-section around week 34 if there’s
concern that blood vessels could burst and
cause severe bleeding.
• Induce delivery at week 40 if you’re delivering the
baby vaginally. The fluid to support pregnancy
lessens and may put more pressure on the blood
vessels.
• Velamentous Cord should be planned to
deliver through cesarean section and thus may
also reduce fetal and neonatal morbidity and
mortality