Gross/Macroscopic Variations and Conditions

Umbilical cord

Furcate insertion

Topic Completed: 1 July 2016

Minor changes: 28 October 2020

Copyright: 2002-2021,, Inc.

PubMed Search: Furcate insertion

Paul J. Kowalski, M.D.
Page views in 2020: 1,846
Page views in 2021 to date: 1,221
Cite this page: Kowalski PJ. Furcate insertion. website. Accessed December 4th, 2021.
Definition / general
  • Grossly visible branching of the umbilical vessels before their insertion onto the placental surface
  • Protective substance, known as Wharton jelly, which covers the umbilical cord is lost at the cord's insertion end
  • Cord displays less tubular integrity and the umbilical vessels divide or branch before reaching the placental surface
  • Umbilical vessels unsupported by Wharton jelly are more subject to shearing forces potentially causing rupture or hemorrhage
  • There are no known causative factors
Clinical features
  • Usually, no clinical significance is associated with furcate insertion
  • Very rarely, fetal hemorrhage has been described
Radiology description
  • Furcate insertion can be detected on an ultrasound scan
Prognostic factors
  • Generally very good, unless the rare situation of hemorrhage from the unprotected portions of vessel occur
Case reports
Gross description
  • Umbilical vessels are seen to divide before reaching the placental surface, usually only involving the distal most 1 - 4 cm of the cord
  • Hemorrhage surrounding the vessels may very rarely indicate vascular rupture
Gross images

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Gross pathology of the placenta

Microscopic (histologic) description
  • Usually no significant microscopic changes are observed
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