Velamentous Cord Insertion: Signs and Treatment

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Pregnancy is a wonderful change and journey in a woman’s life. Through this journey a mother should be careful and aware of all the things during pregnancy. It is important to look after and take care of the signs that may indicate that something is amiss. One of the cases of abnormal pregnancy known is velamentous cord insertion.

velamentous cord insertion

In this article:

What is Velamentous Cord Insertion?
Causes of Velamentous Cord Insertion in Pregnancy
Who is Most at Risk?
Risks Factors for Velamentous Cord Insertion
Signs of a Velamentous Cord Insertion
How is the Diagnosis Done?
How is Velamentous Cord Insertion Treated?
Complication of a Velamentous Cord Insertion
How Can Velamentous Cord Insertion be Prevented?

All you Need to Know about Velamentous Cord Insertion

What is Velamentous Cord Insertion?

Velamentous cord insertion is a case of an abnormal pregnancy in which the umbilical cord is abnormally inserted into the placenta. It is also known as velamentous umbilical cord insertion. In a normal pregnancy, the blood travels from the centre of the placenta into the baby’s blood vessels through the umbilical cord. In velamentous cord insertion, the baby’s blood vessels remain unprotected and Wharton’s jelly a jelly like substance that surrounds them is missing.

In a normal pregnancy, the umbilical cord attaches correctly to the centre but in velamentous cord insertion the cord inserts itself into the amniotic membrane, rather than in the placenta. Also, it’s a rare complication that needs to be regularly monitored by the doctor for a healthy mother and baby. Is can be seen in early pregnancy that is during the second trimester of pregnancy, it can prove to be dangerous if not addressed.

Causes of Velamentous Cord Insertion in Pregnancy

In 90% of pregnancies the umbilical cord inserts normally into the centre portion of the placenta, however this is different in case of a velamentous cord insertion. There are no definitive causes for this, but some can be considered which are as follows –

  • There is a possibility if the mother is older
  • There is a possibility if there is a chance of multiple pregnancies
  • There is a higher possibility if the mother smokes during the pregnancy
  • There is a possibility if miscarriages have occurred in the past

Who is Most at Risk?

Mothers who are older and the ones who are having multiple pregnancies such as twins or triplets are at higher possibility and most risk for a velamentous cord insertion. According to some studies it is a condition which cannot be prevented and can happen to any woman who is in her maternal age.

Risks Factors for Velamentous Cord Insertion

This condition is 9 times more common if it is a twin pregnancy than a single pregnancy. If there is a case of multiple pregnancies then the risk of a velamentous cord insertion is higher for a mother. Also, if the mother smokes then the chances increase more of a velamentous cord insertion. Although, it must be noted that while these have been possible risk factors, there is no guarantee that the pregnant woman will not develop this condition. Utmost care must be taken in such rare cases of pregnancy for healthy life of mother and child both.

Signs of a Velamentous Cord Insertion

The signs are seen in early pregnancy itself, they are –

  • During routine check ups it can be detected a decrease in blood supply to the foetus
  • Growth and development of the foetus compared to standard pregnancy is not up to
  • There is compression of blood vessel
  • There is excessive bleeding and haemorrhage seen during velamentous cord insertion

How is the Diagnosis Done?

The diagnosis of the velamentous cord insertion is easy. One of the best methods is through ultrasound. During the early days of the pregnancy, preferably in the first trimester, it is good to get an ultrasound to check and understand the baby’s growth and development. Also, it is the right time to check for a velamentous cord insertion. Along with ultrasound, physical examination can also be done.

How is Velamentous Cord Insertion Treated?

There is no treatment and medicines for a velamentous cord insertion but precautions can be taken to manage the growth and development of the foetus. By managing complications related to the foetus treatment can be directed. Delivery through an elevated C- section is done to avoid any further complications.

Complication of a Velamentous Cord Insertion

Most of the delivery occurs normally with velamentous cord insertion but several complications can be seen –

  • Preterm birth
  • It can cause the blood flow towards the foetus to reduce thereby affecting its growth and development
  • Less blood flow can also result in intrauterine growth retardation and other related congenital abnormalities
  • Blood vessel compression can cause foetal distress
  • Excessive blood loss during delivery can result in foetal mortality
  • If the velamentous membrane blood vessels are inside the cervical outlet of the uterus, it may rupture leading to early labour and stillbirth. This condition is known as vasa previa.

How Can Velamentous Cord Insertion be Prevented?

There is no clear cut way to prevent this condition from occurring. But, precaution and care can be taken to ensure healthy and safe natal care. It is important for the mother to avoid smoking and drinking during pregnancy as it can lead to many other complications other than velamentous cord insertion. In the majority of the cases, the delivery is normal but do consult a doctor and prepare a proper birth plan if something is diagnosed.

Conclusion

Velamentous cord insertion is a rare condition in which the umbilical cord inserts into the membranes of the developing fetus, instead of the placental disc. It is important to find out this condition at the very beginning of the pregnancy so that proper pregnancy can be done.

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