Which of the following placental abnormalities is characterised by the umbilical cord being inserted at or near the placental margin rather than in the centre?

1. A

   Succenturiate placenta

2. B

   Bipartite placenta

3. C

   Battledore placenta

4. D

   Circumvallate placenta

Appeared in: DSSSB 13 August 2024

Explanation

• A battledore placenta is defined by the marginal insertion of the umbilical cord directly at the edge of the placental disc.
• The name is derived from its resemblance to a battledore, which is a type of racquet used in an early form of badminton.
• This positioning differs from the normal central or eccentric insertion of the umbilical cord.
• The key differentiator is the location of the cord insertion; in a battledore placenta, it is specifically at the margin.

Why Other Options Were Wrong

• Option A: A succenturiate placenta involves the presence of one or more accessory lobes separate from the main placental body. It does not describe the cord's insertion point.
• Option B: A bipartite (or bilobate) placenta is one that is divided into two nearly equal lobes. This term describes the shape of the placenta, not the location of the cord insertion.
• Option D: A circumvallate placenta is characterized by a smaller chorionic plate, which creates a raised, thickened ring of fetal membranes (amnion and chorion) on the fetal surface. This is an abnormality of the placental membranes, not the cord insertion.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of placental and umbilical cord insertion abnormalities as background academic context rather than a clinical decision trigger.
• While many cases of battledore placenta have no adverse outcomes, nurses should be aware of the potential for complications.
• During labor, a marginal cord insertion may be compressed between the fetal presenting part and the maternal pelvis, potentially leading to variable decelerations on the fetal heart rate monitor.
• During the third stage of labor (placental delivery), there is an increased risk of the cord avulsing (tearing away) from the placenta if excessive traction is applied. This can complicate placental removal and increase the risk of postpartum hemorrhage.

How to Approach the Question

• This is a factual recall question that tests your knowledge of obstetrical terminology.
• First, identify the key descriptive phrase in the question stem: 'umbilical cord being inserted at or near the placental margin'.
• Next, review the options and recall the definition for each type of placental abnormality.
• Match the description in the stem to the correct term. 'Battledore' is the specific term for a marginal cord insertion.
• Eliminate the other options by confirming their definitions do not match. Succenturiate refers to an extra lobe, bipartite to two lobes, and circumvallate to a membranous ring.

Concept Tested & Keywords

• Concept Tested: Identification of placental and umbilical cord insertion abnormalities.
• Stem keywords: placental abnormalities, umbilical cord, placental margin, centre
• Lead-in keywords: Which of the following

Question ID

Q9TYrxMdV4QA176tN4FjLK

Copy ID

Reference Book

E6 Obstetrics Williams p. 10-26