Complications of pregnancy: velamentous cord insertion: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Complications of pregnancy: velamentous cord insertion

Sample item

On inspection of a delivered placenta, the umbilical vessels separate from each other at the edge and run through the fetal membranes for some distance, unprotected by Wharton's jelly, before reaching the placental disc. What is this finding?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Velamentous insertion

In velamentous insertion the cord inserts into the membranes, so the unprotected vessels are vulnerable to compression and rupture. It is commoner in twins and with placenta praevia, and when vessels cross the internal os it is called vasa praevia.

Option by option

  • A. Circumvallate placenta

    Circumvallate placenta has a thickened ring on the fetal surface with folded membranes.

  • B. Velamentous insertion (correct)

    Correct. Cord inserted into membranes, with vessels running unprotected to the disc.

  • C. Battledore placenta

    Battledore placenta is a marginal cord insertion at the placental edge, with no membranous vessels.

  • D. Succenturiate lobe

    A succenturiate lobe is an accessory placental lobe connected by vessels in the membranes.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Velamentous insertion. In velamentous insertion the cord inserts into the membranes, so the unprotected vessels are vulnerable to compression and rupture.

Why is "Circumvallate placenta" not the answer?

Circumvallate placenta has a thickened ring on the fetal surface with folded membranes.

Why is "Battledore placenta" not the answer?

Battledore placenta is a marginal cord insertion at the placental edge, with no membranous vessels.

Why is "Succenturiate lobe" not the answer?

A succenturiate lobe is an accessory placental lobe connected by vessels in the membranes.

What concept does this question test?

It tests Complications of pregnancy: velamentous cord insertion in OBG. It is commoner in twins and with placenta praevia, and when vessels cross the internal os it is called vasa praevia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications of pregnancy: velamentous cord insertion?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.