A thesis submitted to the Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, in partial fulfillment of the requirements for Master of Science Degree in Human Anatomy

Abstract

Abstract Introduction: Umbilical cord may insert abnormally either velamentous or marginal insertion to a placenta which can cause different birth and perinatal complications. Despite the increased effort taken by different responsible bodies, the prevalence of birth and perinatal complications are still high, possibly due to anomalous cord insertion. So far, anomalous cord insertion lacks proper attention in different medical settings. Hence, the present study aims to assess the prevalence and risk factors of anomalous cord insertion among singleton births at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods and materials: An institution-based cross-sectional study design was conducted among 421 singleton births at the University of Gondar comprehensive specialized hospital. A systematic random sampling technique was used to select study participants. Data were collected by using a structured questionnaire and checklist and was entered into epi-data version 3.1 then exported to SPSS version 20 for data cleansing and analysis. Bi-variable and multivariable logistic regression was employed to identify factors associated with anomalous cord insertions. Crude and adjusted odds ratio with a 95 % confidence interval were calculated to identify the independent risk factors for anomalous cord insertions. Result: The prevalence of anomalous cord insertion was 9.0% (VCI = 2.6%, MCI = 6.4%) in singleton pregnancies. Independent risk factors for ACI were advanced maternal age (AOR= 4.77), primiparity (AOR=3.87), maternal chronic hypertension (AOR=3.23), previous caesarian delivery (AOR=3.28) and use of IUCD before pregnancy (AOR=3.91). Conclusion and recommendation: The Prevalence and most of the risk factors in the present study are in accordance with previous studies. Marginal cord insertion appears more prevalent (6.4%) than velamentous cord insertion. Routine identification of the placental cord insertion site should be considered in pregnancies with advanced age, nulliparity, hypertensive disorder, history of caesarian section, and IUCD usage before pregnancy. Keywords: prevalence, risk factors, Anomalous cord insertion, singleton births, Gondar, Ethiopi