Perinatal Diagnostic Evaluation of Velamentous Umbilical Cord Insertion: Clinical, Doppler, and Ultrasonic Findings

Abstract

There were substantial differences in pregnancy outcome measures between the subjects with velamentous umbilical cord insertion and controls. Current antepartum methods of tracing uteroplacental problems are not effective in the prenatal detection of abnormal insertion. Therefore, in future studies, the use of other diagnostic tools, such as color Doppler imaging of cord insertion, should be evaluated in high-risk pregnancies followed-up because of fetal growth restriction.

Curves of Placental Weights of Live-Born Twins

“…However, if two separate placentas are present, birthweight (Loos et al, 2001(Loos et al, , 2005 and placental weight are higher. Others speculate that a peripheral cord insertion in combination with the presence of one placental mass could be due to the fact that the delivery of nutrients to the placenta is disturbed if the placentas are fused (Corey et al, 1979;Heinonen et al, 1996;Ramos-Arroyo et al, 1988). Of the twins with one placental mass, the MZ DC twins had the lowest curve.…”

Velamentous cord insertion into the lower third of the uterus is associated with intrapartum fetal heart rate abnormalities

“…Because VCI is associated with fetal growth restriction, preterm labor, placental abruption, vasa previa, abnormal intrapartum fetal heart rate (FHR) patterns, low Apgar scores at 1 and 5 minutes, and neonatal death 1,2 , it has been proposed that detection of VCI should be included in the ultrasound examination during the second trimester 3 -6 . It is thought that frequent FHR abnormalities in VCI cases are caused by a lack of Wharton's jelly, which results in compression of VCI vessels during uterine contractions.…”

Velamentous Insertion of the Umbilical Cord

“…17 Furthermore, the prevalence of velamentous insertion observed in this study (0.9%) was similar to the 1% reported in the second and third trimesters 13,14 and after delivery. 9,10 In summary, this study shows the feasibility of prenatal screening for velamentous umbilical cord insertion at the 11-to 14-week scan. Examination of the placental cord insertion site at this early gestational age may provide a good opportunity for detecting velamentous insertion and close surveillance of the pregnancy for potential complications associated with this condition.…”