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How does abnormal insertion of the umbilical cord cause fetal distress? Fatal risks you don't know about!
Velamentous cord insertion is a pregnancy complication that occurs when the umbilical cord inserts into the fetal membranes. Statistically, this condition is a significant cause of antepartum hemorrhage, can lead to fetal blood loss, and is associated with high perinatal mortality.
In a normal pregnancy, the umbilical cord should be inserted into the center of the placenta and completely wrapped by the amniotic membrane to protect its internal blood vessels. If inserted incorrectly, the fetus' blood vessels are exposed and become susceptible to compression and risk of rupture.
In the case of abnormal insertion of the umbilical cord, the blood vessels of the umbilical cord are not inserted correctly, but intersperse between the amniotic membrane and chorionic membrane, leading to the placenta. This abnormality causes these blood vessels to lose their proper protection, which can lead to compression or rupture. Although its exact cause is unknown, known risk factors include first pregnancy, use of assisted reproductive technology, maternal obesity, and other placental abnormalities.
Warning signs and symptoms
Symptoms of abnormal umbilical cord insertion may be subtle, and many women will not experience any obvious signs during pregnancy. However, the following symptoms may reflect the risk of this complication:
- Fetal blood vessels are compressed, resulting in reduced blood supply, thus affecting fetal growth and development.
- The mother may experience vaginal bleeding during the third trimester.
- During labor, slow or abnormal fetal heart rate patterns and excessive bleeding may occur.
During pregnancy, blood tests may reveal increased levels of HCG and decreased levels of alpha-fetoprotein, both key indicators.
Pathophysiology
Although the specific mechanism that causes abnormal insertion of the umbilical cord is currently unknown, it is generally believed that this abnormality may begin to develop during the first trimester of pregnancy. Theories about placental development state that the placenta moves toward areas with better blood flow, a process that may lead to exposure of umbilical cord blood vessels.
Diagnosis and Management Strategies
Diagnosis of abnormal umbilical cord insertion usually relies on abdominal ultrasound. Generally speaking, ultrasound performed in the second trimester is more effective, but if the placenta is more posteriorly located, a color Doppler or transvaginal ultrasound may be needed to obtain a clearer image.
If abnormal insertion of the umbilical cord is diagnosed, closer monitoring will be performed, especially for the possible coexistence of vasa previa, which further increases the risk of fetal distress.
Potential complications and risk factors
Complications that may result from abnormal insertion of the umbilical cord during pregnancy include placental abruption, fetal growth restriction, abnormal fetal heart rate patterns, and even fetal death. Furthermore, this situation applies especially in the case of multiple gestations.
Common risk factors are as follows:
- First pregnancy
- Use assisted reproductive technology
- Maternal obesity or diabetes
- Older age, etc.
The incidence of abnormal umbilical cord insertion ranges from 0.1% to 1.8%, and in multiple pregnancies, the incidence is even as high as ten times. The presence of this condition may not only affect the growth of the fetus, but may also cause more serious problems, such as unequal weight at birth.
The risks and potential complications associated with abnormal umbilical cord insertion are concerning, but early diagnosis and timely medical intervention can help reduce the impact of this condition on mother and baby. Faced with such risks, are you ready to know how to better protect your own health and the health of your fetus?
