Figure 21. This quadruplet placenta demonstrates many of the complications of multiple gestation. First, the pregnancy was delivered at 28 weeks due to preterm labor. Second, the effects of intrauterine crowding are shown by the thin red-brown cord at 6 o'clock. This cord is velamentously inserted (hard to see in this picture), and belongs to a sibling who died 2 days before delivered. It was believed death was due to cord compression, more common in velamentous cord insertion. Velamentous cord insertion, due to abnormal migration of the placenta, is more common with multiple fetuses and placentas competing for the uterine wall.