Velamentous cord insertion
Velamentous cord insertion is an abnormal condition during pregnancy. Normally, the umbilical cord inserts into the middle of the placenta as it develops. In velamentous cord insertion, the umbilical cord inserts into the fetal membranes (choriamniotic membranes), then travels within the membranes to the placenta (between the amnion and the chorion). The exposed vessels are not protected by Wharton's jelly and hence are vulnerable to rupture. Rupture is especially likely if the vessels are near the cervix, in which case they may rupture in early labor, likely resulting in a stillbirth. This is a serious condition called vasa previa. Not every pregnancy with a velamentous cord insertion results in vasa previa, only those in which the blood vessels are near the cervix.
|Velamentous cord insertion|
|Placenta with velamentous cord insertion.|
When a velamentous cord insertion is discovered, the obstetrician will monitor the pregnancy closely for the presence of vasa previa. If the blood vessels are near the cervix, the baby will be delivered via cesarean section as early as 35 weeks to prevent the mother from going into labor, which is associated with a high infant mortality. Early detection can reduce the need for emergency cesarean sections.
- Figure 1. showing (a) Velamentous cord insertion with rupture of the fetal vein. Clot formation at the site of rupture is clearly seen. (b) Rupture site after removal of the clot in Jantarasaengaram, S; Suthipintawong, C; Kanchanawat, S; Thanagumtorn, K (Jul 2007). "Ruptured vasa previa in velamentous cord insertion placenta". Journal of Perinatology. 27 (7): 457–9. doi:10.1038/sj.jp.7211757. PMID 17592490.