Atypical variable deceleration in the first stage of labor is a characteristic fetal heart‐rate pattern for velamentous cord insertion and hypercoiled cord

@article{Hasegawa2009AtypicalVD,
  title={Atypical variable deceleration in the first stage of labor is a characteristic fetal heart‐rate pattern for velamentous cord insertion and hypercoiled cord},
  author={Junichi Hasegawa and Ryu Matsuoka and Kiyotake Ichizuka and Mihoko Kotani and Masamitsu Nakamura and Takao Mikoshiba and Akihiko Sekizawa and Takashi Okai},
  journal={Journal of Obstetrics and Gynaecology Research},
  year={2009},
  volume={35}
}
Aim:  To evaluate whether various umbilical cord abnormalities, including velamentous, marginal cord insertion (VCI, MCI), hypercoiled cord (HCC) and nuchal cord (NC), affect the appearance of atypical variable deceleration (VD) during labor. 
Umbilical cord length affects the efficacy of amnioinfusion for repetitive variable deceleration during labor.
  • S. Iwagaki, Y. Takahashi, M. Furuhashi
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2020
TLDR
Short umbilical cord length (lower Z-score) was related to emergency CS after therapeutic AI for repetitive variable deceleration, which may offer an important factor for assessing the risk of fetal distress that is difficult to avoid, if methods to accurately determine umbilICAL cord length can be developed.
Velamentous cord insertion: a rare cause of emergency caesarean section
TLDR
The case of a 28-year-old primigravida at 40 weeks gestation, who presented in active phase of labour, highlighted the importance of antenatal diagnosis of VCI and thus preventing catastrophic outcome.
Evaluation of antenatal umbilical coiling index at 16–21 weeks of gestation as a predictor of trisomy 21 and other chromosomal defects
To determine whether there is an association between sonographically assessed hyper‐ or hypocoiling of the umbilical cord and the presence of trisomy 21, to provide reference values for the antenatal
Ultrasound Assessment of the Umbilical Cord
TLDR
The protocol for ultrasound diagnosis and management of umbilical cord abnormalities, including abnor malities of cord insertion, hypercoiled cord, nuchal cord and fore­lying umbilICAL cord, is discussed considering current knowledge regarding the physiological and pathological aspects of these umbilicals.
Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening
TLDR
In studies on limited numbers of cases, screening for VCI using TAS had good overall accuracy, driven by high specificity, and modelling studies may indicate the feasibility and value of studying the epidemiology of VCI and the potential impact of detecting VCI as part of a population screening programme for VP.
Clinical features of velamentous umbilical cord insertion and vasa previa
TLDR
The results suggest that VCI is a moderate risk condition resulted in increased risks of prematurity and impairment of fetal growth.
Evolution of the Fetal Heart Rate Patterns in Cerebral Palsy Associated With Umbilical Cord Troubles: A Nationwide Study
TLDR
Persistent non-reassuring patterns on admission and reactive-PD pattern during the 1st stage of labor were characterized in infants with CP related to umbilical cord troubles coexisting antenatally.
Fetal heart rate evolution patterns in cerebral palsy associated with umbilical cord complications: a nationwide study
TLDR
Hypercoiled cord and abnormal placental umbilical cord insertion, may be associated with CP due to acute hypoxic-ischemic injury as well as sub-acute or chronic adverse events during pregnancy, while umbilICAL cord prolapse may be characterized by acute hyp toxic-ischenic injury during delivery.
A poor long-term neurological prognosis is associated with abnormal cord insertion in severe growth-restricted fetuses
TLDR
The present results indicate that growth-restricted fetuses diagnosed with a birth weight below the 3rd percentile exhibiting abnormal umbilical CI are at a high risk for poor neurological outcomes, including cerebral palsy and/or developmental disorders.
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References

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Velamentous cord insertion into the lower third of the uterus is associated with intrapartum fetal heart rate abnormalities
To evaluate the accuracy of sonographic identification of the site of umbilical cord insertion (CI) at 18–20 weeks of gestation, to compare the sensitivities for detection of a velamentous cord
Velamentous cord insertion and atypical variable decelerations with no accelerations
Intrapartum fetal heart rate monitoring. VIII. Atypical variable decelerations.
Velamentous cord insertion: significance of prenatal detection to predict perinatal complications.
Umbilical Coiling Index in Normal and Complicated Pregnancies
TLDR
Undercoiling and overcoiling of the umbilical cord are associated with increased risk for adverse perinatal outcome.
Nuchal cord is not associated with adverse perinatal outcome
TLDR
Nuchal cord is not associated with adverse perinatal outcome, and labor induction in such cases is probably unnecessary, according to a retrospective population-based study of all deliveries during the years 1988-2003.
Clinical significance and sonographic diagnosis of velamentous umbilical cord insertion.
TLDR
Pregnancy outcomes in VCI patients with 77 singleton gestations were compared with a control group of 15,865 patients and, in contrast to the existing literature, multiparity and prior cesarean section deliveries were not increased in pregnancies with VCI.
Non-Coiled Umbilical Blood Vessels: A New Marker for the Fetus at Risk
TLDR
The findings suggest that the fetus with non‐coiled (ie, straight) umbilical blood vessels is at increased risk for perinatal morbidity and mortality.
The umbilical coiling index.
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