In which of the following conditions does the cord remain attached to the margin of the placenta?

Appeared in: UPPSC-2021

Explanation

A Battledore placenta is defined by the insertion of the umbilical cord directly at the margin or edge of the placental disc.
This condition is also referred to as marginal cord insertion.
The name comes from its resemblance to a battledore, which is an old type of racket used in early versions of badminton.
The image provided clearly illustrates this marginal attachment, confirming the definition.

Option B: Placenta succenturiate refers to the presence of one or more accessory lobes that are separate from the main body of the placenta. The umbilical cord typically inserts into the main placental disc, not necessarily at the margin.
Option C: In a velamentous insertion, the umbilical cord inserts into the fetal membranes (chorion and amnion) rather than directly into the placental disc. The fetal vessels then travel unprotected through the membranes to reach the placenta.
Option D: This option is incorrect because 'Battledore placenta' is the correct medical term for the condition described in the question.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Anatomical variations of placental and umbilical cord insertion as background academic context rather than a clinical decision trigger.
Thorough examination of the placenta after delivery is a critical nursing responsibility. Identifying abnormalities like a succenturiate lobe is vital because a retained lobe can lead to severe postpartum hemorrhage (PPH) and infection.
Identifying a velamentous insertion is important because the unprotected vessels are vulnerable to compression or rupture during labor and delivery, which can lead to fetal distress or exsanguination (vasa previa).
What if the question described vessels crossing the cervical os? If the vessels from a velamentous or succenturiate placenta run over the internal cervical os, the condition is called vasa previa, a critical obstetric emergency requiring a planned cesarean delivery to prevent fetal hemorrhage upon membrane rupture.

How to Approach the Question

First, identify the key phrase in the question: "cord remain attached to the margin of the placenta."
This is a factual recall question that requires knowledge of placental anatomy and its variations.
Review the definitions of each option provided.
Match the definition of marginal cord insertion with the correct term.
Battledore placenta is the specific term for marginal insertion.
Eliminate the other options based on their definitions: Placenta succenturiate involves an extra lobe, and velamentous insertion involves the cord attaching to the membranes.

Concept Tested & Keywords

Concept Tested: Anatomical variations of placental and umbilical cord insertion.
Stem keywords: cord, attached, margin, placenta
Lead-in keywords: In which

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E6 Obstetrics Williams p. 10-26

Practise the full UPPSC-2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.