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Velamentous Cord Insertion: Causes, Symptoms, Treatment, Risk Factors, Complications

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What is Velamentous Cord Insertion?

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Velamentous cord insertion is a condition which is usually seen in an abnormal pregnancy. The umbilical cord is inserted into the center of the placenta as it further grows. In this Velamentous condition, the umbilical cord is inserting in the middle of the fetal membranes. Further it moves into the membranes to the placenta. This is the position between the amnion and the chorion where the exposed vessels are not at all protected by the jelly called Wharton. Here, the vulnerable membrane tends to rupture.

When vessels are close to the cervix, then rupture stage appears. Now the pregnant lady goes into labor and may result into a stillbirth. The Velamentous cord insertion is not considered as a normal condition because this may take place in 1 out of 100 pregnancies. The abnormality in the insertion of umbilical cord is also known in medical terms as Vasa Previa. However, this is the acute stage of Velamentous cord insertion so every woman does not suffer through the same situation of stillbirth.

Therefore, when Velamentous cord insertion is diagnosed then the gynecologist will examine the pregnancy seriously for the appearance of vasa previa. In case the blood vessels comes close to the cervix, then doctor will suggest C-section operation as early as possible to 35 weeks so that mother could not go to the natural labor pains because it may lead to the death of the infant inside the womb.

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Velamentous Cord Insertion
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What Causes Velamentous Cord Insertion?

There are no considered factors causing Velamentous cord insertion. However, there are some reasons which studies shows on different pregnant women who suffered from the same issue-

  • Age of the Mother- if the mother is above 35 years of age or had difficulty in getting pregnant since years.
  • Smoking during the pregnancy can cause Velamentous cord insertion as well as several other complications arises.
  • Several miscarriages in past or already had multiple successful pregnancies previously.

How is Velamentous Cord Insertion Diagnosed?

The Velamentous cord insertion can be diagnosed by a physical examination executed by the radiologist or the gynecologist. Ultrasound is the most accurate method to know the internal condition. Therefore, at the first stage Velamentous cord insertion requires no medical treatment and the results are usually good in majority cases. Only in some cases, it develops to the last stage, but a doctor keeps monitoring the progress. If doctor examines some serious condition after entering the third trimester, then c section will be recommended immediately. The doctor will wait till 35 weeks only so that the patient could not enter into the phase of labor.

Who Can Experience Velamentous Cord Insertion?

Velamentous cord insertion prevails in 1 patient out of 100 in total. It can occur in any age group, while risk is fatal in old age women in comparison to the young females (age between 18 to age 30). There is one more situation in which Velamentous cord insertion takes place and i.e. when a woman is pregnant with two different gender of fetus.

What is the Risk Factor for Velamentous Cord Insertion?

  • In twin pregnancy the chances of miscarriage is higher than the single pregnancy. The risk of baby’s life is 9 times more than the other normal conditions. 
  • Premature delivery through C-section is probably 99% sure in this type of case
  • The risk of mother’s life as well as baby is determined during the birth of the child through labor pain process.

Is The Reason Behind the Development of Velamentous Cord Insertion Unknown?

The reason behind the Velamentous insertion of umbilical cord is actually unknown but according to Re-searches, it is said that placental tissue abnormal development creates the Velamentous cord insertion.

Symptoms of Velamentous Cord Insertion

  • Excessive bleeding at the time of childbirth is the main signal that there was some sort of problem in placenta
  • Compression of the blood vessel
  • Blood flow towards the fetus during second trimester is considered via color Doppler ultrasound and if the blood flow is below average then further analysis is prescribed by the doctor immediately due to the risk of Velamentous cord insertion.

What All Possible Complications Are Seen Till Date in Velamentous Cord Insertion?

Risk factors for Velamentous cord insertion includes some complications at different degrees some are mentioned below-

  • Birth of the child before its due date. This is called preterm birth and not likely to be said as good for the baby. Usually pregnancies which are diagnosed with velamentous insertion of the umbilical cord are suggested for the early c- section so that the baby could not lead to a situation where blood flow is limited and it results to death inside the womb.
  • Once blood flow decreases at the third trimester stage of the pregnancy, it results into IUGR i.e. intrauterine growth retardation and even other type of congenital abnormalities are seen in the developing baby.
  • With such problem, many pregnancies in the world end up during 1st or 2nd trimester unknowingly. When diagnoses are conducted then it is observed that the placenta was the problem behind unsuccessful pregnancy.
  • Fetal mortality causes when excessive bleeding is caused and this happens mostly when the above mentioned condition prevails.
  • When blood vessels of the Velamentous membrane are found in the cervical outlet which is located near the uterus, then the chances of rupture are chief because of early labor process. The fetus born in such conditions are still and in medical terms doctors call the problem as vasa previa.

What is the Treatment for Velamentous Cord Insertion?

There is no such medical treatment for the Velamentous cord insertion into the placenta because everything is happening on its own inside the womb and no one can touch the fluid or womb from inside by tools even to change the position of the umbilical cord. However, doctors treat the patient by monitoring the fetus growth, placenta position on each 4 week of the pregnancy. Therefore, couples are suggested to go for the cesarean section operation rather than opting for a normal child birth via labors to avoid complications.

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Is There Any Way To Avoid Velamentous Cord Insertion?

Till date science has taken up a huge niche in the world, but this is something impossible to prevent. There is no such medicine or treatment by which Velamentous cord insertion can be prevented. Only complications are forecasted by the doctor after seeing the first trimester ultrasound because such kind of growth is foreseen clearly in the second or third ultrasound scan on the uterus. If its growth rate is very fast, then abortion is recommended to save the agony and life of the mother.

Final Thought

The condition is favorable for single pregnancies, still there are no sure shot prognosis by the doctor’s because every pregnancy is different and complications are distinct. Some pregnancies are successfully carried up to 38 weeks with the placenta vasa previa, whereas some are recommended with immediate C-section to save the life of the fetus and other complications.

However, labor pain method is totally not suggested by the doctors whether complications are less of higher. C-section is the only way couple has to select for the delivery of the baby safely.

References:

  1. American Journal of Perinatology Reports. (2018). Velamentous Cord Insertion: A Case Report and Review of the Literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179615/
  2. Seminars in Perinatology. (2011). Velamentous cord insertion: significance and management. https://www.sciencedirect.com/science/article/pii/S0146000511001031
  3. Journal of Obstetrics and Gynaecology Canada. (2009). Velamentous Cord Insertion: Weighing the Risks. https://www.jogc.com/article/S1701-2163(16)34201-2/fulltext

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 3, 2023

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