Velamentous cord insertion 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
Umbilical cord prolapse should be suspected if there is a sudden decrease in the babies heart rate during labor. Seeing or feeling the cord confirms the diagnosis. Management focuses on quick delivery, usually by cesarean section. Filling the bladder or pushing up the baby by hand is recommended until this can take place. The knee-chest position, or if this is not possible Trendelenburg position may be used. With appropriate management, the majority of cases have good outcomes. Umbilical cord prolapse occurs in about 1 in 500 pregnancies. The risk of death of the baby is about 10%. Much of this risk is due