Velamentous Cord Insertion Pregnancy Complications

 

Marginal Cord Insertion

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I have a marginal cord insertion. Are there any risks associated with this?

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Velamentous insertion of the umbilical cord

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Marginal Cord Insertion Placenta Experience | Pregnancy Birth Vlog

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Velamentous cord insertion is a rare pregnancy complication that poses a danger to the health of the mother and baby. By Karen Samuels Aug 13, 2020 Most of the changes experienced during pregnancy are common, while some are abnormal and uncommon. One such abnormality is velamentous cord insertion. The exact mechanisms leading to insertion of the umbilical cord in the fetal membranes are unknown, although they are likely to occur in the first trimester. One theory is that velamentous cord insertion may arise from the process of placental trophotropism, which is the phenomenon where the placenta migrates towards areas which have better blood flow with advancing gestation.

The placenta grows in regions with better blood supply and portions atrophy in region. Introduction: A velamentous cord insertion (VCI) describes a peripheral umbilical cord insertion to the placenta with blood vessels from the cord traversing fetal membranes before reaching the placental margin. These vessels remain unprotected and exposed to pressure and injury during pregnancy and labor. It increases fetal mortality.

Sometimes velamentous insertion of the umbilical cord can compress the vessels and decrease blood flow. This can lead to growth retardation of the fetus. The risk of spontaneous abortion also increases, especially in. A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery. de Los Reyes S(1), Henderson J(2), Eke AC(2). Author information: (1)Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Risk factors and adverse pregnancy outcomes among births affected by velamentous umbilical cord insertion: a retrospective population-based register study. The results suggest that the incidence of VCI increases along with an increase in fertility problems and maternal obesity. VCI is a moderate risk condition increasing the risks of prematurity and impaired fetal growth. Velamentous cord insertion is a case of an abnormal pregnancy where the umbilical cord is abnormally inserted into the placenta. In a normal pregnancy, the blood travels from the centre of the placenta into the baby’s blood vessels via the umbilical cord.

With a velamentous cord insertion, the baby’s blood vessels remain unprotected, and the jelly-like. Velamentous cord insertion causes. Velamentous cord insertion cause is not well established. However, velamentous cord insertion was more commonly found in placenta praevia, assisted reproductive conception and multiple pregnancies 12).. The placenta is a maternal-fetal organ which begins development at implantation of the blastocyst, and it is.

I had a velamentous cord insertion as well as a 2 vessel cord with my last pregnancy. I saw a high risk OB so they could take a good look at his heart and kidneys as these develop at the same time as the cord and could have issues. A VCI can also cause growth restriction so you would usually get extra monitoring to ensure growth.

Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case-control study. Yerlikaya G(1), Pils S(1), Springer S(1), Chalubinski K(1), Ott J(2). Author information: (1)Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria.

List of related literature:

A succenturiate placenta is at an increased risk for a velamentous cord insertion and is a possible cause of a vasa previa.

“Sonography Exam Review: Physics, Abdomen, Obstetrics and Gynecology E-Book” by Susanna Ovel
from Sonography Exam Review: Physics, Abdomen, Obstetrics and Gynecology E-Book
by Susanna Ovel
Elsevier Health Sciences, 2019

Velamentous cord insertion increases the risk for PPH and manual removal of the placenta (Ebbing, Kiserud, Johnsen et al., 2015).

“Skills for Midwifery Practice Australia & New Zealand edition” by Sara Bayes, Sally-Ann de-Vitry Smith, Robyn Maude
from Skills for Midwifery Practice Australia & New Zealand edition
by Sara Bayes, Sally-Ann de-Vitry Smith, Robyn Maude
Elsevier Health Sciences APAC, 2018

On the other hand, late clamping of the cord could cause overinfusion with placental blood and the possibility of polycythemia and hyperbilirubinemia, a particular concern in preterm infants.

“Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family” by Adele Pillitteri
from Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family
by Adele Pillitteri
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010

Delayed cord clamping increases the risk of neonatal polycythemia and jaundice.

“Labor and Delivery Nursing: Guide to Evidence-Based Practice” by Michelle Murray, PhD, RNC, Gayle Huelsmann, BSN, RNC
from Labor and Delivery Nursing: Guide to Evidence-Based Practice
by Michelle Murray, PhD, RNC, Gayle Huelsmann, BSN, RNC
Springer Publishing Company, 2008

If the cord inserts peripherally and the umbilical vessels splay at the placenta, velamentous insertion of the cord is likely.

“Clinical Maternal-Fetal Medicine” by Hung N. Winn, John C. Hobbins
from Clinical Maternal-Fetal Medicine
by Hung N. Winn, John C. Hobbins
Taylor & Francis, 2000

A very short cord may cause premature separation of the placenta from the wall of the uterus during delivery.

“The Developing Human E-Book” by Keith L. Moore, T. V. N. Persaud, Mark G. Torchia
from The Developing Human E-Book
by Keith L. Moore, T. V. N. Persaud, Mark G. Torchia
Elsevier Health Sciences, 2011

Finally, a velamentous cord insertion was suggested to increase the risk for TTTS, and cord insertions can be reliably determined at 16 weeks.

“High Risk Pregnancy E-Book: Management Options Expert Consult” by David K. James, Philip J. Steer, Carl P. Weiner, Bernard Gonik
from High Risk Pregnancy E-Book: Management Options Expert Consult
by David K. James, Philip J. Steer, et. al.
Elsevier Health Sciences, 2010

The cord may insert reasonably close to the edge of the placenta or far away from it.

“Pathology of the Human Placenta” by Kurt Benirschke, Graham J. Burton, Rebecca N Baergen
from Pathology of the Human Placenta
by Kurt Benirschke, Graham J. Burton, Rebecca N Baergen
Springer Berlin Heidelberg, 2012

Such things as a marginal cord insertion, where the cord is low lying and may lie over the cervical os during delivery, should be excluded.

“Fundamentals of Emergency Ultrasound” by John P. McGahan, Michael A Schick, Lisa Mills
from Fundamentals of Emergency Ultrasound
by John P. McGahan, Michael A Schick, Lisa Mills
Elsevier Health Sciences, 2019

Planning for insertion in an area remote from the placenta decreases risk for iatrogenic abruption.

“Pfenninger and Fowler's Procedures for Primary Care E-Book: Expert Consult” by John L. Pfenninger, Grant C. Fowler
from Pfenninger and Fowler’s Procedures for Primary Care E-Book: Expert Consult
by John L. Pfenninger, Grant C. Fowler
Elsevier Health Sciences, 2010

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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5 comments

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  • Thank you for sharing this with us. I haven’t personally gone through this type of experience, but I have gone through an experience where my unborn child probably wouldn’t make it through birth. I remember the fear I felt and the extreme powerlessness. This is where our faith comes in. Our Faith that Heavenly Father has a plan for us, we don’t know what that is.
    I appreciate that you show your emotions. You have every right to, and by doing this others will see that it is okay to feel too. You are brave and a warrior. Thank you for sharing this. I will be praying for you, the baby, and your beautiful family.

  • Thank you! This is a relief…I just found out today that I have marginal cord insertion. Is there anything we can do in addition to support growth and nutrients to the baby?

  • Congratulations on your pregnancy and you look radiant!!! I’m also pregnant and 34 weeks today so looking forward to following your journey along. I have a highly risk pregnancy (even though everything is going well so far) so I understand that trusting G-d is all we can do. I love this type of video

  • Hey Sarah! I loved this video and I’m so happy you and your baby was healthy! My son had marginal cord insertion, and my OB said it was nothing to worried about but to get routine growth ultrasound. Unfortunately he ended up having IUGR and was induced at 38 weeks at 5lb 1oz:) he’s a happy healthy boy now!

  • I had hypermesis my second pregnancy and all I wanted was a big beautiful bump and didn’t get one till 8 months. Woman all over would even question if I was pregnant. It made me very salty and upset because I longed for a bump and not to be sick anymore. You rock that bump! ♥️