Velamentous Insertion of the Umbilical Cord

Sepúlveda, Waldo

doi:10.7863/jum.2006.25.8.963

Cited by 99 publications

(19 citation statements)

References 15 publications

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“…When VCI was detected, the patient underwent sonography again two weeks later by another MFM specialist. The MFM specialist performed either a transabdominal or transvaginal scan (Figure 1) [12]. The VCI group was defined as VCI in one or both of the fetuses.…”

Section: Methodsmentioning

confidence: 99%

Clinical Significance of Velamentous Cord Insertion Prenatally Diagnosed in Twin Pregnancy

Lee

Park

et al. 2021

JCM

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Background: The purpose of this study was to evaluate the prevalence of velamentous cord insertion (VCI) and the actual association between pathologically confirmed VCI and perinatal outcomes in twins based on the chorionicity. Methods: All twin pregnancies that received prenatal care at a specialty clinic for multiple pregnancies, from less than 12 weeks of gestation until delivery in a single institution between 2015 and 2018 were included in this retrospective cohort study. Results: A total of 941 twins were included in the study. The prevalence of VCI in dichorionic (DC) twins and monochorionic diamniotic (MCDA) twins was 5.8% and 7.8%, respectively (p = 0.251). In all study population, the prevalence of vasa previa and placenta accreta spectrum was higher in VCI group than that of non-VCI group (p = 0.008 and 0.022). In MCDA twins with VCI, birth weight, 1 and 5-min Apgar score were lower than DC twins with VCI (p = 0.010, 0.002 and 0.000). There was no significant association between VCI and selective fetal growth restriction (p = 0.486), twin-to-twin transfusion syndrome (p = 0.400), and birth-weight discordance (>20% and >25%) (p = 0.378 and 0.161) in MCDA twins. Conclusion: There was no difference in the incidence of VCI in twins based on the chorionicity. Moreover, VCI was not a risk factor for adverse perinatal outcomes excepting vasa previa and placenta accreta spectrum, which had a high incidence in twins with VCI.

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Section: Methodsmentioning

confidence: 99%

Clinical Significance of Velamentous Cord Insertion Prenatally Diagnosed in Twin Pregnancy

Lee

Park

et al. 2021

JCM

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“…These pregnancies are at greater risk for adverse perinatal outcome, including fetal growth restriction, preterm birth, congenital anomalies, fetal distress, low Apgar scores, and fetal demise. 4,9 Conclusion Using the tapping technique (i.e., the tap sign), entrapment of the vasculature within the floating membranes can be demonstrated by sonography. Identification of a VIUC by using color flow Doppler sonography while gently tapping the maternal abdomen (i.e., the tap sign) prior to the onset of labor and/or rupture of the membranes is essential to allow time for appropriate medical management to be formulated and patient teaching to be conducted.…”

Section: Discussionmentioning

confidence: 98%

Antepartum Sonographic Identification of Velamentous Insertion of the Umbilical Cord via Color Doppler

Murphy

Pollaci

2007

Journal of Diagnostic Medical Sonography

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A woman in her early 40s, gravida 1, presented at 9 weeks' gestation for prenatal care. A firsttrimester nuchal translucency measurement at 12.3 weeks' gestation was 1.3 mm. The Ultra-Screen reported an increased risk for Down syndrome. A genetic amniocentesis performed at 17.5 weeks' gestation indicated an extra chromosome 21 (Down syndrome), xx fetus. A sonographic examination performed at 21.0 weeks' gestation by an outside perinatal facility revealed a single intrauterine female fetus with a posterior placenta, adequate amniotic fluid volume, and a normal fetal echocardiography. At 30.5 weeks' gestation, the patient presented with fetal size slightly greater than dates. An in-office sonogram was performed using a 3.75-MHz curvilinear transducer real-time scanner (Toshiba Eccocee) showing adequate fetal growth and an amniotic fluid index of 21.4 cm. A subsequent in-office sonogram at 34.4 weeks, performed to reevaluate the amniotic fluid index, demonstrated membranes floating in the amniotic fluid in the left lateral lower quadrant. From Suffolk OB-GYN, Patchogue, NY. Correspondence: Colleen Murphy, RDMS, Suffolk OB-GYN,

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“…The feasibility of prenatal screening for umbilical cord insertion, which enables the detection of vasa praevia during first trimester screening, has already been demonstrated [ 8 , 9 ]. In the mid-trimester, detection is also possible with a high overall predictive reliability (sensitivity 100%, specificity 99.8%), as reported previously [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Risk-adapted management for vasa praevia: a retrospective study about individualized timing of caesarean section

Yerlikaya-Schatten

Chalubinski

Pils

et al. 2019

Arch Gynecol Obstet

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Purpose Vasa praevia is a rare condition with high foetal mortality if not detected prenatally. There is limited evidence available to determine the ideal timing of delivery and management recommendations. The aim of this study was to critically review our experience with vasa praevia, with a focus on diagnosis and management. Methods In a retrospective analysis, all cases of vasa praevia identified in our department from January 2003 to December 2017 were included. All cases were diagnosed antenatally during sonographic inspection of the placenta, and individualized management for each patient was performed based on individual risk factors. 19 cases of vasa praevia were identified (15 singletons, four twins). 13 patients (79%) presented placental anomalies. In patients at high risk for preterm birth, caesarean delivery was performed between 34–35 weeks after early hospitalization and administration of corticosteroids, whereas in patients at low risk for preterm birth, caesarean section could be delayed to 35–37 weeks of gestation. Administration of corticosteroids was not obligatory in the latter cases. Results There were two acute caesarean sections, due to premature abruption of the placenta and vaginal bleeding. There was no maternal or foetal/neonatal death. None of the neonates required blood transfusion. There is limited evidence available with which to determine the ideal timing of delivery. Conclusion However, our individualized, risk-adapted management, which attempts to delay the timing of caesarean section up to two weeks beyond the standard recommendation, seems feasible, with just two emergency caesarean sections and no case of foetal or maternal death.

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Velamentous Insertion of the Umbilical Cord

Cited by 99 publications

References 15 publications

Clinical Significance of Velamentous Cord Insertion Prenatally Diagnosed in Twin Pregnancy

Clinical Significance of Velamentous Cord Insertion Prenatally Diagnosed in Twin Pregnancy

Antepartum Sonographic Identification of Velamentous Insertion of the Umbilical Cord via Color Doppler

Risk-adapted management for vasa praevia: a retrospective study about individualized timing of caesarean section

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