What Is Velamentous Cord Insertion?- Expert Reviews & Guide

Velamentous Cord Insertion

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The baby’s umbilical cord connecting to your placenta is known to be the lifeline of the baby, and if there are any abnormalities or complications in the way of attachment to the placenta, could, unfortunately, put the pregnancy at higher risk of complications. Therefore, it is quite essential perhaps to make sure to avoid any abnormal cord insertion.

Velamentous cord insertion, on the other hand, is a rare umbilical cord abnormality that may require monitoring in your pregnancy, and with proper care, there are chances of it ending up not being problematic for both, the pregnancy and the baby.

What is velamentous cord insertion?

According to obstetrics and gynecology, the fetus’ blood vessels in a normal pregnancy run via the umbilical cord directly into the placenta of the mother. However, a velamentous insertion is when the placental cord insertion from a fetus abnormally gets inserted on the edge of the placenta, with the chorioamnionitis membranes that cause the fetal blood vessels to travel unprotected from the placenta until they combine and reach the protection of the umbilical marginal cord insertion.

This rare pregnancy complication occurs in 1 percent of the singleton pregnancies and in up to 15 percent of identical twin pregnancies, where a single placenta is shared by both fetuses. However, the cause is not entirely clear as to why it occurs but fortunately, it does not cause any serious problems and you’ll only require more monitoring during pregnancy and when giving birth.

How is the velamentous umbilical cord insertion diagnosed?

The best way to diagnose a placental cord insertion site is by the help of the ultrasound in obstetrics that helps view the images of the placenta and umbilical cord that is seen in the second trimester, and in the first trimester scans in some cases. Also, a more definitive diagnosis can be made in the third stage of labor, where the pathologist can inspect the placenta.

Diagnosis of the velamentous umbilical cord: How does it happen and what are the risk factors involved?

There are no clear timelines to know of the velamentous and marginal umbilical vessels but this velamentous cord insertion (VCI) is generally detected in the second-trimester ultrasound.

Here are the circumstances in which the risks involved in the detection of velamentous insertion:

  • Women with placenta previa or vasa previa are at slightly higher risk
  • Pregnant moms with monochorionic twins, that are identical twins sharing the same placenta
  • There are researches that show, IVF pregnancies to have a higher chance of the complication
  • If you are older in age, you may have a chance of developing the velamentous cord insertion condition.

Pregnancy complications in a velamentous cord insertion?

Listed below are the complications that result due to the velamentous cord insertion:

  • If there is compression or a rupture of umbilical cord blood vessels

This may lead to the umbilical cord blood vessels closest to the placenta to be unprotected in a velamentous cord insertion, especially when these vessels are located close to the cervix. Also true in cases of vasa previa, where the fetal blood vessels run close to the cervical opening.

  • An emergency C-section

If there is an unprotected vessel rupture during labor, there might be a need for an emergency C-section.

  • Manual removal of the placenta post-delivery

Moms with velamentous cord insertion do end up in need of a manual placenta removal post-birth.

  • Hemorrhage while in labor

Most other women experience an increased risk of hemorrhage during the delivery of the placenta.

Note, in the complications mentioned above, there will be a need for close monitoring, as well as, top-notch medical care for prevention of the velamentous umbilical cord insertion.

Could the velamentous cord insertion hurt the baby?

According to the American Journal Of Obstetrics, the insertion of the umbilical cord will not hurt the baby or has quite a low array. However, the ultrasound Obstet Gynecol has mentioned that it could have effects like increased risk of preterm birth, a gestational age baby, a low Apgar score, and would need for a stay in the neonatal intensive care unit (NICU) post-birth for safety.

Perhaps, in the twin pregnancies with velamentous cord insertion, there is a higher risk of intrauterine growth restriction affecting one or both the babies.

What are the precautions taken to aid the velamentous cord insertion by the Obstet Gynecol?

  • In case you are said to have a velamentous cord insertion, you would have frequent ultrasounds to monitor the condition of the baby and the placenta, also to know if it is all proceeding healthily.
  • You might as well have the growth of the baby tracked with a few important and mandatory weekly testings like a nonstress test or ultrasounds.
  • And, if things go well, the doctor wouldn’t induce you early but will also avoid you to go longer than 40 weeks. With the absence of vasa previa or placenta previa, the chances of C-section based on a diagnosis of velamentous cord insertion alone.
  • During the time of labor, there would be continuous monitoring for the fetal heart rate, making sure of no complications caused by the abnormal cord placement.
  • Post-delivery, the practitioner might not pull on the cord for the placenta to detach compared to the normal cord insertion cases. That means you wouldn’t have to birth the Baby(s) placenta that is a part of the third stage of pregnancy.

To Conclude

Most of you might as well look for alternatives in order to prevent the velamentous cord insertion, unfortunately, there isn’t any other alternative and it at times just happens for no apparent reason in the fetal development. However, there are no serious problems caused and with the help of the practitioner, this abnormal cord insertion can be aided with more ultrasounds and constant monitoring during your pregnancy and childbirth.

FAQs: Velamentous Cord Insertion: Explained

1) How serious is Velamentous cord insertion?

This pregnancy complication is one of the rare complications that seem in pregnant moms. The abnormal insertion occurs in about a percent of singleton pregnancies and up to 15 percent in identical twin pregnancies sharing the same placenta. However, the good news here is that it rarely causes any serious problems and all you'll need is monitoring.

2) What do you do if you have Velamentous cord insertion?

There is nothing that you could do to aid the abnormal cord insertion per se but the best part is that it has no serious complication and can be aided. It is diagnosed through an ultrasound by the Obstetrics and Gynecology in the first trimester of your pregnancy but is easily visualized in the second trimester. There are chances of a C-section if you are diagnosed with the velamentous umbilical cord insertion.

3) What compares marginal and VCI?

A VCI is when the umbilical vessels get inserted into the membranes even before they reach the placental. However, on the other hand, the marginal insertion is where the distance between the two is reduced to a minimum, via an insertion site that supports quite a small placental tissue.
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