Original Research Article DOI: 10.18231/2394-2126.2017.0082 Indian Journal of Clinical Anatomy and Physiology, July-September, 2017;4(3):324-328 324 Variable placental attachment of umbilical cords and its effects on placental outcomes Ankit Jain 1,* , Rashmi Jain 2 , Sonia Baweja 3 1 Ex. Resident, 3 Associate Professor, Dept. of Anatomy, Gandhi Medical College, Bhopal, Madhya Pradesh, 2 Lab Head, Consultant Pathologist, Dept. of Pathology, SRL Diagnostics Ltd., Bhopal, Madhya Pradesh *Corresponding Author: Email: ankitjain6285@gmail.com Abstract Introduction: Growth of the fetus is dependent on the development and function of the placenta. Therefore, any pathological condition which affects the function of placenta, will also affects the fetal outcomes. The aim of the present study was to assess the effects of non-central cord insertions on placental outcomes. Materials and Method: 120 placentae divided into sixty each of normotensive and pre-eclamptic pregnancies were studied. After delivery, the weight of the placenta was taken by using weighing machine. The shape of the placenta and umbilical cord insertion on placenta was observed. Results: In this study, abnormal cord insertions were found 2.57 times more in pre-eclamptic pregnancies as compared to normal pregnancies. Altered shaped placentae were found 2.6 times more in pre-eclamptic pregnancies as compared to normal pregnancies. We found that 28.57% and 55.56% placentae with abnormal cord insertion were associated with altered placental shapes in normal and pre-eclamptic pregnancies respectively. We also observed that 57.14% and 77.78% placentae with abnormal cord insertion were associated with low placental weight in normal and pre-eclamptic pregnancies respectively. Conclusion: The incidence of abnormal cord insertions were more in pre-eclamptic pregnancies and these abnormal cord insertions were significantly associated with altered shaped placentae and lower placental weight. Conclusively, placenta with abnormal cord insertion may be associated with alteration in the function of the placenta, which ultimately affects the fetal outcomes. Keywords: Cord insertion, Pre-eclampsia, Placenta, Placental shape, Placental weight. Received: 23 rd January, 2017 Accepted: 25 th March, 2017 Introduction During intrauterine life, placenta and umbilical cord act as a connecting link between fetus and mother. All the essential nutrients needed for fetal growth and development comes from the mother’s blood and fetal waste products pass back to the mother’s blood through the placenta and umbilical cords; hence an examination of the placenta and umbilical cord gives a clear idea about the fetal outcomes when it was in the mother’s womb. The placenta is a discoidal organ, which has fetal and maternal surfaces. The fetal surface is covered by an amnion and umbilical cord is attached to the center of this fetal surface. The maternal surface is finely granular and has 15-30 lobes. These lobes correspond to the major branches of distribution of the umbilical vessels. (1) Placenta regulates the growth and survival of the fetus during intrauterine life. The growth of the placenta is not uniform in intrauterine life. It undergoes different changes in shape, weight, and function continuously. (2) In the early gestational period, the shape of the placenta is not round, but irregularly- regular with a few large branches and gaps between them. In a normal course of development of placental vasculature, the main branches of the placental vascular tree grow first, then smaller branches fills the gaps between main branches. Thus the placental shape becomes round from irregular. Any disease which affects the utero-placental vascular pathology may also alter the placental angiogenesis. Thus the overall placental shapes remain irregular in these diseases (3) and these irregular shaped placentae are associated with reduced placental efficiency which impacts negatively on the fetal development. (4) Abnormalities in the site of insertion of umbilical cord on placenta can produce a number of complications in pregnancies i.e. preterm labour, vasa previa. (5,6) These complications have potential to affect the fetal health and well-being. Low birth weight, IUGR (intrauterine growth retardation), low APGAR (appearance, pulse, grimace, activity and respiratory rate) score, and increased rate of fetal malformation has been associated with abnormal cord insertions. (7-9) The aim of present study was to compare the distribution of variable placental attachment of umbilical cord and placental shapes in normal and pre- eclamptic pregnancies; and to evaluate the effects of variable cord insertions on placental shapes and weight. Materials and Method The study was conducted in the Department of Anatomy, Gandhi Medical College, Bhopal (M.P.). After permission from the institutional ethics committee, a total of 120 placentae were collected from