Does site of Insertion of cord at placenta matters??

Part  1:.

Marginal /Velamentous  Insertion  of the Cord . An exaggerated form   of eccentric insertion occurs in 7% of pregnancies with insertion of the cord at the margin of the placenta. This is known as battledore   placenta. In 1% of Pregnancies the cord inserts beyond the  placental edge into the free membranes of the placenta. This  is known as velamentous insertion of the cord and may be complicated  by rupture and  thrombosis of the  umbilical  vessels  because   they are not   protected by Wharton jelly.

Part  2:.

Developmental issues:- As the placenta develops it is believed to grow preferentially in areas of optimal   myometrial perfusion and atrophy in areas of suboptimal blood supply . As a result the cord insertion may become somewhat eccentric (commonest) despite  its initial  central attachment. This process is referred   to as trophotropism. Developmental aspects in embryonic life: Early in development the embryo rotates such that the yolk sac and adjacent connecting stalk are positioned opposite the implantation site. This allows the umbilical cord to insert centrally within the placenta

Part 3:-Foeatal & maternal risks: Pregnancies with velamentous cord insertion are at risk for the development of  fetal growth   restriction,  prematurity , congenital   anomalies.  fetal bleeding,    retained placenta and fetal demise. Vasa previa results from velamentous insertion of the cord with umbilical vessels crossing the cervical os. Such variations in placental insertion of the umbilical cord including marginal and velamentous insertions can be detected by USg. In a study   of the feasibility of identifying velamentous insertion of the cord using grayscale and color Doppler USG the placental cord insertion site was identified I. 9%  of cases .  Assessment of placental cord insertion site on obstetric USG potentially can identify   pregnancies with velamentous insertion and    therefore those at  risk for obstetric  complications including  vasa previa . Velamentous insertion of the umbilical   cord is also   often seen in one fetus of a MC twin pregnancy.