what condition is it when the umbilical cords is not attached to the placenta

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What Is Velamentous String Insertion?

A velamentous string insertion is a rare pregnancy complication in which the umbilical cord is abnormally inserted into the placenta. In a normal gestational sac, the umbilical cord is inserted into the middle of the placenta (key insertion) and entirely enclosed in the amniotic sac. The baby's claret vessels travel from the center of the placenta into the baby via their umbilical cord.

In a velamentous insertion, the umbilical cord inserts itself into the amniotic membrane rather than in the placenta. The baby's claret vessels stretch along the membrane between the insertion point and the placenta. Equally such, the vessels are unprotected because the substance that typically surrounds them, Wharton'southward jelly, is missing.

The crusade of velamentous cord insertion is unknown, and this abnormality is not the merely one of its kind. There is as well the possibility of a marginal insertion, in which the placement of the umbilical string is less than ii centimeters sideways of the placental margin, or edge of the placenta. Occurring in about 7% of single-baby pregnancies, a marginal string insertion can develop into a velamentous insertion.

Signs of Velamentous Cord Insertion

In that location are several signs that may indicate velamentous cord insertion. One such indicator, which may be detected by your healthcare provider during a routine ultrasound, is a subtract in fetal blood supply.

If a fetus is non hitting developmental milestones during your prenatal appointments, information technology could be another sign that there is a complication similar a velamentous cord insertion. Additionally, if you feel haemorrhage during pregnancy, bring this to the attention of your medico or midwife.

Diagnosis

Velamentous cord insertion can be diagnosed through an ultrasound. It may be difficult to see during the commencement trimester of pregnancy, but it is easier to detect during the 2nd trimester.

Prevalence

Velamentous insertion occurs in 1.1% of unmarried-babe pregnancies and viii.7% of twin pregnancies. This type of insertion is more common earlier in pregnancy. In cases of miscarriage, velamentous cord insertion happens around 33% of the time when the pregnancy ends between 9 and 12 weeks gestation. In pregnancies that terminate betwixt 13 and 16 weeks, the rate is a piddling lower at 26%.

Risks

Risk factors for developing a velamentous cord include having a ii-lobed placenta, uterine anomalies, and the fetus having a unmarried umbilical artery. Other take chances factors to consider are:

Advanced maternal age
Having a female person fetus
Having twins
Pregnancies conceived with assisted reproductive technology like in vitro fertilization (IVF)
Prior abnormal cord insertion in pregnancy

Complications

Velamentous string insertion tin lead to complications for the fetus. One time the baby is born, they may exist more than likely to be transferred to the neonatal intensive care unit of measurement (NICU). They may take a low Apgar score (a ranking of a baby's concrete status), an abnormal heart rate, or other physical problems.

Although rare and less of a risk when properly monitored, velamentous insertion as well increases the risk of stillbirth. There are boosted complications of which expecting parents should exist enlightened too.

Vasa Previa

Velamentous string insertion could result in a potentially serious pregnancy complication called vasa previa. Vasa previa occurs when the baby's blood vessels run shut to the inner part of the cervix—the tissue that separates the uterus from the vagina.

Because of their location, the baby's blood vessels are at risk of rupturing. The status tin can exist fatal, with approximately 50% of undiagnosed cases leading to fetal death. Approximately vi% of single-baby pregnancies with velamentous cord insertion will also accept vasa previa.

If vasa previa is detected during pregnancy with an ultrasound, at that place is a 97% to 99% chance that the infant will survive. In one case diagnosed, the pregnant person will be scheduled to deliver the baby past Cesarean section at around 34 - 37 weeks gestation.

Pocket-size for Gestational Age

A velamentous cord can restrict fetal growth. Equally a result, it increases the chances of having a newborn who is minor for gestational age (SGA). These babies may be less adult or weigh less than a typical infant of the same age. SGA can besides pb to issues in newborns, such as:

Hypoglycemia (low claret sugar)
Polycythemia (high ruby blood prison cell counts)
Hyperbilirubinemia (which may cause seizures/brain harm)
Hypothermia (depression body temperature)

Preeclampsia

Preeclampsia could go an outcome for pregnant people with velamentous string insertion. Hallmarks of this disease are high blood pressure level (hypertension) and failure of the liver and/or kidneys. If detected during early pregnancy, information technology is possible for sure medications to be prescribed to mitigate the effects of preeclampsia. Delivering the infant is the only way to end preeclampsia, and so a planned preterm birth may be required.

Premature Birth

Velamentous cord insertion may necessitate a preterm commitment. This could entail the pregnant person being induced for labor earlier than anticipated, or it could involve a C-department birth. Placental implantation abnormalities, including velamentous string insertion, are the cause of 5.6% to 8.vii% of preterm deliveries.

Emergency Cesarean Section

A 2020 study of more 500 cases of velamentous string insertion noted that 16.1% of the pregnant people involved required an emergency C-section. Early detection of a cord aberration via ultrasound can reduce the likelihood of an emergency Cesarean, pending an otherwise low-adventure pregnancy.

Treatment

Although there is no known prevention or handling for velamentous string insertion, the best class of action, in one case it is discovered, is to get regular ultrasounds and closely monitor the fetus. Your healthcare provider may also suggest a nonstress exam in the third trimester. This comprises wearing a belt with built-in sensors and tracking the baby'south movement and heart charge per unit.

Frequently Asked Questions

Why does velamentous string insertion happen in multiple pregnancies?

It is not known why velamentous string insertion occurs in multiple pregnancies, but it does happen more frequently in multiple than in singleton pregnancies.

Does velamentous cord insertion affect a baby's brain?

A velamentous string insertion tin indirectly lead to brain damage in ii ways. During childbirth, the baby'due south blood vessels may tear, preventing the babe from getting enough oxygen. This result, chosen hypoxic ischemic encephalopathy (HIE), can lead to brain impairment. Around 39% of HIE cases involve velamentous or marginal cord insertion.

A velamentous cord insertion can too restrict fetal growth. Babies who are pocket-size for gestational age are also at risk for a condition called hyperbilirubinemia. This can lead to encephalon damage that occurs in utero. However, go along in mind that a velamentous cord insertion is a rare occurrence, and so encephalon harm is non likely.

Can velamentous cord insertion right itself?

No, velamentous cord insert cannot correct itself.

Tin can velamentous cord insertion cause birth anomalies?

Yes, velamentous cord insertion can crusade birth anomalies such equally an abnormal eye rate, a baby being small for gestational age, and other complications associated with preterm nativity should an early on delivery exist required.

A Give-and-take From Verywell

Velamentous cord insertions may pose serious complications for parent and child, simply it is important to remember that they are rare. When they do happen, at that place is nevertheless a skillful chance of a positive effect with close monitoring. If you accept concerns, be sure to speak with your healthcare provider to determine the best class of activeness for your pregnancy.

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Source: https://www.verywellfamily.com/velamentous-cord-2371665