Velamentous Insertion of the Umbilical Cord

@article{Sepulveda2006VelamentousIO,
  title={Velamentous Insertion of the Umbilical Cord},
  author={Waldo Sepulveda},
  journal={Journal of Ultrasound in Medicine},
  year={2006},
  volume={25}
}
  • W. Sepulveda
  • Published 1 August 2006
  • Medicine
  • Journal of Ultrasound in Medicine
Objective. The purpose of this study was to determine the feasibility of prenatal sonography for detecting velamentous insertion of the umbilical cord in singleton pregnancies at the 11‐ to 14‐week scan. Methods. The placental umbilical cord insertion site was prospectively examined at the time of the routine first‐trimester scan between 11 and 14 weeks as part of ongoing first‐trimester sonographic screening for chromosomal abnormalities. Results. Over a 1‐year period, 533 consecutive… 
Velamentous cord insertion: is it associated with adverse perinatal outcomes?*
  • T. Esakoff, Yvonne W. Cheng, J. Snowden, S. Tran, B. Shaffer, A. Caughey
  • 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
  • 2015
TLDR
VCI is associated with an increased risk of adverse perinatal outcomes such as intrauterine fetal demise, SGA, preterm delivery <37 weeks, need for manual removal of placenta and post-partum hemorrhage.
Antenatal Detection of Abnormal Placental Cord Insertion across Different Trimesters: A Prospective Cohort Study.
TLDR
Abnormal PCI can be detected antenatally with optimal agreement with postnatal classification in T2, however, the incidence is overestimated at early scans with low PPVs.
Obstetric Outcomes in Singleton Pregnancies with Abnormal Placental Cord Insertions.
TLDR
The results suggest that serial fetal growth assessments in this population may be warranted, and if an abnormal PCI is identified, the provider should consider serial growth ultrasounds.
Performance of ultrasound for the visualization of the placental cord insertion.
TLDR
Although the visualization of the PCI was lower with advancing gestational age, it remained high even into the late third trimester, and Ultrasound with color Doppler is also an excellent screening test for the diagnosis of VCI.
Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case–control study
TLDR
The last pulsatility index value in the umbilical artery, before delivery, was significantly higher in pregnancies with VCI, which is of uncertain clinical value, and higher rates of (early) preterm delivery were found.
Umbilical cord insertion site in early gestation and development of placenta
TLDR
The process of placental development and the placental location are affected by CI location at early gestation, and suggests that this process might be affected by poor blood supply from the low uterine segment when CI site is close to the internal cervical Os.
First trimester assessment of ductus venosus in screening for fetal chromosomal and cardiac defects
TLDR
It is suggested that flow through the ductus venosus can be assessed routinely at 11-13 weeks of gestation and that abnormal flow at this scan can help identify fetal chromosomal and structural defects as well as adverse pregnancy outcome.
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.
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.
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References

SHOWING 1-10 OF 20 REFERENCES
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.
Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study
TLDR
The aim of this study was to determine the feasibility of identifying velamentous insertion of the umbilical cord during routine obstetric ultrasound.
Using fetal nuchal translucency to screen for major congenital cardiac defects at 10-14 weeks of gestation: population based cohort study
TLDR
Measurement of fetal nuchal translucency thickness—traditionally used to identify fetuses at high risk of aneuploidy—at 10-14 weeks of gestation can identify a large proportion of fetuses with major defects of the heart and great arteries.
Fetal exsanguination from ruptured vasa previa: still a catastrophic event in modern obstetrics
  • J. Robert, W. Sepulveda
  • Medicine
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2003
TLDR
An emergency caesarean section was performed, delivering a very pale male fetus weighing 2040 g with Apgar scores of 0 and 0 at 1 and 5 minutes, respectively, and full resuscitation efforts were stopped at 20 minutes.
Antenatal diagnosis of velamentous umbilical cord insertion and vasa previa with color Doppler imaging
  • M. Nomiyama, Y. Toyota, H. Kawano
  • Medicine
    Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
  • 1998
To determine whether cord insertion can be consistently visualized and whether velamentous cord insertion and vasa previa can be consistently identified with color Doppler imaging during routine
VELAMENTOUS INSERTION OF THE CORD IN EARLY PREGNANCY.
  • I. W. Monie
  • Medicine
    American journal of obstetrics and gynecology
  • 1965
THE CLINICAL SIGNIFICANCE OF MARGINAL AND VELAMENTOUS INSERTION OF THE CORD
TLDR
A study of 1000 cases has failed to demonstrate any association between marginal and velamentous insertion of the cord and high incidence of abortion, low birth weight, premature delivery, fetal malformation, fetal hypoxia and intrauterine fetal death.
Screening for pre‐eclampsia and fetal growth restriction by uterine artery Doppler at 11–14 weeks of gestation
To examine the value of uterine artery Doppler at 11–14 weeks of gestation in the identification of women at risk of developing pre‐eclampsia and fetal growth restriction.
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