In this article:
Knowing what to expect and maintaining good communication with your healthcare professional will help you feel more confident and prepared.
What is Velamentous Insertion of Cord?
Velamentous cord insertion occurs when the umbilical cord attaches to the foetal membranes (chorion and amnion) surrounding the placenta instead of directly to the placenta itself. Normally, the umbilical cord connects your baby to the placenta and allows the transfer of nutrients, oxygen, and waste. In this condition, the blood vessels from the cord travel through the membranes to reach the placenta without the protective gel-like substance called Wharton’s jelly. This lack of protection makes the vessels more vulnerable to compression or rupture, which could affect your baby’s blood and nutrient supply.Causes and Risk Factors
The cause of velamentous cord insertion is not fully known. But certain medical and pregnancy-related factors increase the chances of it occurring. These are the main ones you should know:- It’s more common in twin pregnancies, especially when twins share a single placenta (monochorionic diamniotic twins).
- Pregnancies achieved through in vitro fertilisation (IVF).
- First-time parents: Individuals pregnant for the first time.
- Individuals over 35 years of age.
- Placenta previa (a condition where the placenta is located low in the uterus and partially or completely covers the cervix)
- Uterine abnormalities (structural issues in the uterus).
- Smoking or chronic conditions like diabetes.
- While infections or genetic factors might influence placental development, there’s no clear evidence linking them directly to this condition.
Symptoms of Velamentous Cord Insertion
You might not notice any symptoms with velamentous cord insertion. However, some signs could indicate a problem:- Vaginal bleeding: Unexplained bleeding may suggest complications, especially in the third trimester.
- Abnormal foetal heart rate: A slow or irregular heart rate could signal foetal distress.
- Signs of preterm labour: Regular contractions or lower back pain before your due date may occur.
Diagnosis of Velamentous Cord Insertion
Diagnosing this condition usually happens during routine prenatal scans. Your doctor may use the following methods to confirm it:- Ultrasound: A detailed ultrasound, typically during the second trimester (around 20 weeks), can show the umbilical cord’s insertion point. This is part of the standard anatomical survey.
- Colour Doppler ultrasound: This provides a clearer image of blood flow in the umbilical vessels with a high accuracy rate in detecting the condition in research settings.
Velamentous Cord Insertion Treatment Options
There’s no direct treatment to correct velamentous cord insertion, but careful management can reduce risks. Your healthcare professional may recommend:- Frequent monitoring: Regular ultrasounds every 4 to 6 weeks to track your baby’s growth, starting around 24 weeks.
- Non-stress tests: These safe tests track your baby’s heart rate and movements to check they are getting enough oxygen.
- Hospital admission: You may be admitted for continuous monitoring closer to delivery.
- Planned caesarean section: If vasa previa is present or there’s a risk of blood vessel rupture, a caesarean section may be scheduled around 34 weeks.
- Vaginal delivery precautions: If no major complications are present, vaginal delivery may be possible by 40 weeks. Careful monitoring is required to avoid pressure on the vessels.
- Corticosteroids: These may be given to help your baby’s lungs mature if early delivery is planned.
Complications of Velamentous Cord Insertion
Though complications are rare, velamentous cord insertion can lead to serious issues if not managed properly:- Foetal distress: Unprotected vessels may compress, reducing blood flow and oxygen to your baby.
- Preterm birth: You might need to deliver early, which increases the chance of premature birth.
- Low birth weight: Your baby may grow more slowly due to reduced nutrient supply.
- Vasa previa: Unprotected vessels near the cervix can rupture during labour and cause heavy bleeding for you or your baby. This can lead to stillbirth, but having a planned caesarean section can improve the chances of survival.
- Placental abruption: The placenta may detach from the uterine wall prematurely.
- Neonatal ICU care: Babies may need extra care due to low birth weight or low Apgar scores (a test assessing breathing, heart rate, and other vitals at birth).
- Maternal haemorrhage: You may experience heavy bleeding during or after delivery. You may experience heavy bleeding during or after delivery. In some cases, this may need manual placenta removal or uterine scraping.
- In the long term, babies may have growth delays or neurological problems if their oxygen supply is affected. But this is rare when proper medical care is given.
Prevention Strategies
There is no guaranteed way to prevent velamentous cord insertion since it happens during foetal development, and the exact cause is still unknown. However, you can take steps to support a healthy pregnancy:- Regular prenatal care: Attend all scheduled appointments to catch potential issues early.
- Healthy lifestyle: Avoid smoking, alcohol, and illicit drugs, which can affect foetal health.
- Balanced diet: Eat foods rich in folic acid, iron, and other nutrients to support development.
- Good hygiene: This helps prevent infections that could impact your pregnancy.
- Stay vaccinated: Keep up with recommended vaccinations to reduce infection risks.
Living with Velamentous Cord Insertion
If you’re diagnosed with this condition, your healthcare professional will guide you on how to manage it. They may suggest limiting certain activities or increasing rest as delivery approaches. These are a few steps you can follow:- Follow medical advice: Stick to your doctor’s recommendations for monitoring and activity levels.
- Ask questions: Discuss safe exercise, dietary needs, rest, and sleep with your doctor to create a plan for your pregnancy.
- Stay calm: While the diagnosis can feel overwhelming, complications are rare with proper care, and most pregnancies result in healthy babies.
When to Seek Medical Attention
Contact your healthcare professional immediately if you notice:- Heavy vaginal bleeding.
- Severe abdominal pain.
- Sudden changes in your baby’s movements.
- Signs of preterm labour such as regular contractions or lower back pain.
Velamentous cord insertion may sound concerning, but the risks can be managed effectively with close monitoring. The outlook for pregnancies with this condition is generally positive with early diagnosis and proper medical support. Most babies are born healthy, and the birthing parent recovers well.
FAQs on Velamentous Cord Insertion in Pregnancy
- What causes velamentous cord insertion?
The exact cause is unknown but risks increase with twin pregnancies, IVF, first pregnancies, older maternal age, and uterine or placental issues. - How is velamentous cord insertion diagnosed?
It is usually found during routine ultrasounds, often in the second trimester. Colour Doppler ultrasound may also be used in some cases to check blood flow. - What complications can arise from velamentous insertion of cord?
Possible issues include foetal distress, preterm birth, low birth weight, placental abruption, and maternal bleeding during delivery.