Labor and Delivery — MCQs

Q: What is the term for an umbilical cord attached to the margin of the placenta?

Battledore placenta. **Explanation:** The correct answer is **Battledore placenta**, also known as **Marginal insertion of the cord**. **1. Why Battledore Placenta is correct:** In a normal pregnancy, the umbilical cord typically inserts near the center of the placental mass (eccentric or central insertion). In a **Battledore placenta**, the cord is attached at the very margin or edge of the placenta. The name is derived from its resemblance to a "battledore" (an early form of a badminton racket). While often an incidental finding, it can be associated with preterm labor or fetal growth restriction if the marginal attachment compromises blood flow. **2. Analysis of Incorrect Options:** * **Circumvallate placenta:** This is a morphological abnormality where the chorionic plate is smaller than the basal plate, causing the fetal membranes to "double back" around the edge, forming a whitish ring. It is a placental disc issue, not a cord insertion issue. * **Velamentous insertion:** Here, the cord inserts into the **fetal membranes** (amnion and chorion) rather than the placental mass itself. The umbilical vessels run unprotected through the membranes before reaching the placenta. * **Vasa previa:** This occurs when fetal vessels (often from a velamentous insertion or succenturiate lobe) run across the internal os of the cervix, placing them at high risk of rupture during labor. **High-Yield Clinical Pearls for NEET-PG:** * **Velamentous insertion** is the precursor to **Vasa previa**. * The classic triad of Vasa previa: **Rupture of membranes + Painless vaginal bleeding + Fetal bradycardia/distress.** * **Battledore placenta** is more common in multiple gestations and IVF pregnancies. * If the cord is attached to a small extra lobe separated from the main placenta, it is called a **Succenturiate lobe**.

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Physiology of Labor

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Stages of Labor and Normal Progression

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Fetal Monitoring Techniques

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Pain Management in Labor

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Induction and Augmentation of Labor

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Operative Delivery (Forceps and Vacuum)

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Cesarean Section: Indications and Techniques

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Dystocia and Abnormal Labor Patterns

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Obstetric Emergencies

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Postpartum Hemorrhage Management

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