Velamentous insertion of the umbilical cord corresponds to the insertion
of the cord directly on amniotic membranes. It is a rare situation whose
frequency varies from 0.5% to 1.69% of single pregnancies. It must be diagnosed
during the morphological ultrasound of the 2nd trimester, actively looking for
the association with a vasa previa, due to the risk of fetal haemorrhagic
threat. We report an antenatal diagnosis of velamentous cord insertion and its
management with literature review.
References
[1]
Eddleman, K.A., Lockwood, C.J., Berkowitz, G.S., Lapinski, R.H. and Berkowitz, R.L. (1992) Clinical Significance and Sonographic Diagnosis of Velamentous Umbilical Cord Insertion. American Journal of Perinatology, 9, 123-126.
https://doi.org/10.1055/s-2007-994684
[2]
Heinonen, S., Ryynanen, M., Kirkinen, P. and Saarikoski, S. (1996) Perinatal Diagnostic Evaluation of Velamentous Umbilical Cord Insertion: Clinical, Doppler, and Ultrasonic Findings. Obstetrics & Gynecology, 87, 112-127.
https://doi.org/10.1016/0029-7844(95)00339-8
[3]
Kent, E.M., Breathnach, F.M., Gillan, J.E., et al. (2011) Placental Cord Insertion and Birthweight Discordance in Twin Pregnancies: Results of the National Prospective ESPRiT Study. American Journal of Obstetrics & Gynecology, 205, 376.e1-7.
https://doi.org/10.1016/j.ajog.2011.06.077
[4]
Schachter, M., Tovbin, Y., Arieli, S., et al. (2002) In vitro Fertilization Is a Risk Factor for Vasa Previa. Fertility and Sterility, 78, 642-643.
https://doi.org/10.1016/S0015-0282(02)03253-3
[5]
Suzuki, S. and Kato, M. (2015) Clinical Significance of Pregnancies Complicated by Velamentous Umbilical Cord Insertion Associated with Other Umbilical Cord/Placental Abnormalities. Journal of Clinical Medicine Research, 7, 853-856.
https://doi.org/10.14740/jocmr2310w
[6]
Ruiter, L., Kok, N., Limpens, J., et al. (2015) Systematic Review of Accuracy of Ultrasound in the Diagnosis of Vasa Previa. Ultrasound in Obstetrics & Gynecology, 45, 516-522. https://doi.org/10.1002/uog.14752
[7]
Catanzarite, V., Maida, C., Thomas, W., et al. (2001) Prenatal Sonographic Diagnosis of Vasa Previa: Ultrasound Findings and Obstetric Outcome in Ten Cases. Ultrasound in Obstetrics & Gynecology, 18, 109-115.
https://doi.org/10.1046/j.1469-0705.2001.00448.x
[8]
Antoine, C., Young, B.K., Silverman, F., et al. (1982) Sinusoidal Fetal Heart Rate Pattern with Vasa Previa in Twin Pregnancy. Journal of Reproductive Medicine, 27, 295-300.
Gagnon, R., Morin, L., Bly, S., Butt, K., Cargil, Y.M., Denis, N., et al. (2010) Diagnostic Imaging Committee; Maternal Fetal Medicine Committee. SOGC Clinical Practice Guideline: Guidelines for the Management of Vasa Previa. International Journal of Gynecology & Obstetrics, 108, 85-89.
[11]
Bohîlțea, R.E., Cîrstoiu, M.M., Ciuvica, A.I., et al. (2016) Velamentous Insertion of Umbilical Cord with Vasa Praevia: Case Series and Literature Review. Journal of Medicine and Life, 9, 126-129.
[12]
Muller, P. and Dellenbach, P. (1968) Anomalies du cordon ombilical et malformations foetales. Revue Française de Gynécologie et d’Obstétrique, 63, Article 601.
[13]
De Los Reyes, S., Henderson, J. and Eke, A.C. (2018) A Systematic Review and Meta-Analysis of Velamentous Cord Insertion among Singleton Pregnancies and the Risk of Preterm Delivery. International Journal of Gynecology & Obstetrics, 142, 9-14. https://doi.org/10.1002/ijgo.12489
[14]
Sinkin, J.A., Craig, W.Y., Jones, M., et al. (2018) Perinatal Outcomes Associated with Isolated Velamentous Cord Insertion in Singleton and Twin Pregnancies. Journal of Ultrasound in Medicine, 37, 471-478. https://doi.org/10.1002/jum.14357
[15]
Cipriano, L.E., Barth, W.H. and Zaric, G.S. (2010) The Cost-Effectiveness of Targeted or Universal Screening for Vasa Praevia at 18-20 Weeks of Gestation in Ontario. BJOG, 117, 1108-1118. https://doi.org/10.1111/j.1471-0528.2010.02621.x
[16]
McQueen, V., Speed, M., Rutter, S. and Gray, T. (2018) Vasa Praevia: Should We Routinely Screen High-Risk Women for This Rare But Serious Condition? Ultrasound, 26, 127-131. https://doi.org/10.1177/1742271X17747137
[17]
Jauniaux, E., Alfirevic, Z., Bhide, A.G., et al. (2019) Vasa Praevia: Diagnosis and Management: Green-Top Guideline No. 27b. BJOG, 126, e49-e61.
https://doi.org/10.1111/1471-0528.15307
[18]
Hasegawa, J., Matsuoka, R., Ichizuka, K., Sekizawa, A. and Okai, T. (2006) Velamentous Cord Insertion: Significance of Prenatal Detection to Predict Perinatal Complications. Taiwanese Journal of Obstetrics and Gynecology, 45, 21-25.
https://doi.org/10.1016/S1028-4559(09)60185-6
