How to Management Velamentous Cord Insertion?

Insertion velamentous – a rare umbilical cord auroral

The umbilical cord supplies the unborn child with oxygen and all vital nutrients from the mother’s blood. The breakdown products of his metabolism are disposed of in the same way. In 70 percent of all pregnancies, the umbilical cord’s insertion is in the middle of the placenta – medically, this normal condition is called “insertion central.” In the remaining cases, the umbilical cord either attaches to the placenta (Insertion paracentral, Insertion marginalis) or inserts – altogether very seldom – as Insertion velamentous directly into the membranes.

In singleton pregnancies, this umbilical Cordura is found in 1 percent of all pregnancies. With multiple pregnancies, the probability increases.

Since the vessels attach directly to the skin, it can come early in pregnancy to compress individual umbilical vessels.

An insertion velamentous was long recognized as a chance finding only during or after birth. In the case of a child born healthy and uncomplicated, no consequential damage is expected afterward. However, the umbilical cord auricular syndrome can be detected much earlier in the ultrasound.

DEGUM, the German Society for Ultrasound in Medicine, now demands to include the early detection of umbilical cord anomalies in the standardized prenatal care to avoid later complications. However, most obstetricians are already looking for it today.

High risk of birth complications and deficiencies in pregnancy

Although the insertion velamentous is rare, it can be dangerous for the unborn child.

Due to the free insertion of the umbilical vessels in the egg skin, individual vessels’ compression can occur at an early stage. If this occurs during the embryonic phase and the baby’s oxygen supply suffers greatly, it can lead to malformations. In 25 percent of cases, insertion velamentous is associated with non-chromosomal (non-hereditary) abnormalities of the embryo.

Fetal bleeding during childbirth

The baby’s greatest danger is at an Insertion but velamentous during a possibly necessary amniocentesis ( amniocentesis ), and especially during the birth if an umbilical vessel is injured. Particularly risky here is the bubble jump.

If the umbilical cord set in the fetal membranes is directly or very close to the internal cervix (vasa praevia), one or more umbilical vessels may rupture during the rupture of the bladder. This leads to acute oxygen deficiency. At the same time, the child runs the risk of bleeding within a few minutes.

If there is vaginal bleeding during the bladder’s rupture, doctors will always think of Insertion Velamentous. If fetal hemoglobin – HbF, the child’s red blood pigment – is detected in this blood, the birth is initiated immediately. Depending on the child’s degree of risk, this can be done by cesarean section or vaginally.

Although an emergency C-section is no longer sufficient, the child is brought by so-called vacuum extraction (Perfusion Toulousienne). His vital functions are supported by medication immediately after intensive care treatment is necessary.

Prevention of complications from a planned cesarean section

However, such serious complications of insertional velamentous are rare today. If umbilical cord anomaly is known, obstetricians often plan a premature cesarean section, which is usually between the 36th and the completed 37th week of pregnancy, depending on the pregnancy’s individual course.

The right time for the cesarean section is determined in the context of the so-called risk-adaptive care of pregnant women. Among other things, the risk of premature birth and the cervix’s maturity and cervix are taken into account. Professor Wolfgang Henrich, head of the obstetric department at the Berlin Charité, emphasizes that today almost all children are born healthy with an insertion velamentous.

If the umbilical cord begins far away from the inner cervix, natural birth is not impossible from his point of view. Of course, the heartbeat and the general condition of the child are monitored very carefully.

Very close monitoring in pregnancy

If the baby is already suffering from deficiency symptoms before insertion due to an insertion velamentous, doctors will consider whether and when premature birth is advised to avoid permanent damage. However, the pregnancy often proceeds without any problems despite the umbilical cord auroral.

In any case, the mother and child are closely monitored following this diagnosis. It is sporadic for an insertion velamentous to recur in a subsequent pregnancy.

If you are worried that your baby is affected by an umbilical cord anomaly, you should consult your gynecologist. After the ultrasound examination and perhaps also a fine ultrasound, he will almost always be able to give you the all-clear.

Even if, contrary to expectations, you should receive the diagnosis “Insertion velamentous,” there is no reason to panic. Your doctors will make sure that your baby is well and ensures the greatest possible safety during birth. You may also enjoy your pregnancy. If your child has survived the risky first three months, you will very likely soon be embracing a healthy baby.