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Prenatal ultrasound diagnosis of velamentous cord insertion: a case report and review of the literature

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Abstract

Purpose

The velamentous cord insertion is a rare pathology in which the umbilical blood vessels branch before reaching the placenta; by varying its structure, the cord becomes prone to spontaneous internal ruptures. This pathology is an obstetric emergency, so its early diagnosis is essential.

Methods and results

We present a 27-year-old pregnant woman who attends an antenatal check-up for a routine third-trimester examination. Ultrasound reveals grade I polyhydramnios and suggestive findings of a trivascular umbilical cord with velamentous insertion 35 mm from the nearest placental border. The ultrasound diagnosis allowed a term delivery by elective cesarean section, avoiding severe complications of the maternal–fetal binomial.

Conclusion

Velamentous cord insertion can and should have an early prenatal diagnosis, even from the second trimester, through imaging techniques such as transabdominal ultrasound or color Doppler. Early detection and appropriate peripartum management will highly reduce complications during labor.

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Data availability

The data that support the findings of this study are available from the corresponding author, [MFE], upon reasonable request.

References

  1. O’Quinn C, Cooper S, Tang S, Wood S (2020) Antenatal diagnosis of marginal and velamentous placental cord insertion and pregnancy outcomes. Obstet Gynecol 135(4):953–9. https://doi.org/10.1097/AOG.0000000000003753

    Article  PubMed  Google Scholar 

  2. Sánchez Gutiérrez L, Martos Ortega N, Reillo Flokrans M, Rodríguez Ingelmo JM (2011) Inserción velamentosa extrema de cordón umbilical, sin rotura de vasa previa. Prog Obstet Ginecol. 54(9):473–5. https://doi.org/10.1016/j.pog.2011.04.013

    Article  Google Scholar 

  3. Siargkas A, Tsakiridis I, Pachi C, Mamopoulos A, Athanasiadis A, Dagklis T (2023) Impact of velamentous cord insertion on perinatal outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 5(2):100812. https://doi.org/10.1016/j.ajogmf.2022.100812

    Article  PubMed  Google Scholar 

  4. Stevenson R, Hall J, Everman D, Solomon B (2015) Human malformations and related anomalies. Oxford University Press, New York

    Book  Google Scholar 

  5. Matsuzaki S, Ueda Y, Matsuzaki S, Kakuda M, Lee M, Takemoto Y et al (2022) The characteristics and obstetric outcomes of type II Vasa previa: systematic review and meta-analysis. Biomedicines 10(12):3263. https://doi.org/10.3390/biomedicines1012326

    Article  PubMed  PubMed Central  Google Scholar 

  6. Buchanan-Hughes A, Bobrowska A, Visintin C, Attilakos G, Marshall J (2020) Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening. Syst Rev 9(1):147. https://doi.org/10.1186/s13643-020-0135

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kr D, Parashuram R (2020) Study of variations in human placental attachment of umbilical cord and its clinical significance. Int J Anat Res. 8(12):7333–7337

    Google Scholar 

  8. Ferrero Viñas A, Cortejoso Hernández J, de Miguel Manso S, Suárez Mansilla P, Álvarez Colomo C, González Martín JI (2020) Vasa previa, diagnóstico prenatal y manejo obstétrico. Clin Invest Ginecol Obste 47(1):18–21. https://doi.org/10.1016/j.gine.2019.06.002

    Article  Google Scholar 

  9. Delagrange H, Hindryckx A, van Schoubroeck D, Richter J (2021) A velamentous and furcate cord insertion in a vasa previa setting: A rare but potentially lifethreatening condition. Case report and review of the literature. J Case Rep Images Obstet Gynecol 7:100082Z08DH2021

  10. Matínes-Jiménez M, Anaya Baz M, Gambacorti Passerini Z, Vivar del Hoyo P, Bejarano Ramírez N, García Cabezas MA (2018) Presentación de dos casos de vasa previa, ¿se podría haber evitado el desenlace? Rev esp ped. octubre de 74(1):5–7

  11. Gagnon R (2017) No 231-guidelines for the management of Vasa previa. J Obstet Gynaecol Can. 39(10):e415-21. https://doi.org/10.1016/j.jogc.2017.08

    Article  PubMed  Google Scholar 

  12. Bigelow CA, Robles BN, Pan S, Overbey J, Robin E, Melamed A et al (2021) Placental cord insertion distance from the placental margin and its association with adverse perinatal outcomes. Obstet Gynecol Surv 76(5):251–2. https://doi.org/10.1097/01.ogx.0000751632.76307.ed

    Article  Google Scholar 

  13. Zaghal AA, Hussain HK, Berjawi GA (2019) MRI evaluation of the placenta from normal variants to abnormalities of implantation and malignancies. J Magn Reson Imaging 50(6):1702–17. https://doi.org/10.1002/jmri.26764

    Article  PubMed  Google Scholar 

  14. Kelley BP, Klochko CL, Atkinson S, Hillman D, Craig BM, Sandberg SA et al (2020) Sonographic diagnosis of velamentous and marginal placental cord insertion. Ultrasound Q 36(3):247–54. https://doi.org/10.1097/RUQ.0000000000000437

    Article  PubMed  Google Scholar 

  15. Castillo-Urquiaga W, Ventura-Laveriano WR, Limay-Ríos A, Zarate-Girao MI, Sugajara-Rosario RR, Ibáñez-Rodríguez CE et al (2019) Parámetros de evaluación diferenciados para la ecografía obstétrica estándar versus la especializada. Recomendación del servicio de medicina fetal 2019. Investigación Materno Perinatal 8(1):49–55. https://doi.org/10.33421/inmp.2019144

    Article  Google Scholar 

  16. Messawa M, Ma’ajeni E, Daghistani MH, Ayaz A, Farooq MU (2012) The role of doppler ultrasound in high risk pregnancy: a comparative study. Niger Med J 53:116–20. https://doi.org/10.4103/0300-1652.104377

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Servicio de Obstetricia y Ginecología, Hospital Departamental San Antonio de Roldanillo, Roldanillo, Valle del Cauca, Colombia

    Jorge A. Potosí-García, Julian H. Velez-Varela & Rosa H. Morales-Benítez

  2. Facultad de Ciencias de la Salud, Universidad de Caldas, Manizales, Caldas, Colombia

    Juliana Velez-Tamayo

  3. Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cra 98 Nro.18-49, 760032, Cali, Valle del Cauca, Colombia

    Evelyn E. Peña-Zarate

  4. Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra 98 Nro.18-49, 760032, Cali, Valle del Cauca, Colombia

    Maria F. Escobar-Vidarte

  5. Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Valle del Cauca, Colombia, Calle 18 No. 122 -135

    Maria F. Escobar-Vidarte

Authors
  1. Jorge A. Potosí-García
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  2. Julian H. Velez-Varela
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  3. Rosa H. Morales-Benítez
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  4. Juliana Velez-Tamayo
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  5. Evelyn E. Peña-Zarate
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  6. Maria F. Escobar-Vidarte
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Contributions

JAPG, JHVV, RHMB and JVT contributed to the material preparation, data collection, and draft of the manuscript. EEPZ and MFEV contributed to the revision and finalization of the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Maria F. Escobar-Vidarte.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hospital Departamental San Antonio de Roldanillo E.S.E (February 24, 2023. Act No. 1).

Consent to participate

Written informed consent was obtained from the patient described in the above case.

Consent for publication

The authors affirm that the patient described in the above case provided written informed consent for submission of the case report for publication, including the publication of the figures.

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Potosí-García, J.A., Velez-Varela, J.H., Morales-Benítez, R.H. et al. Prenatal ultrasound diagnosis of velamentous cord insertion: a case report and review of the literature. J Ultrasound 27, 173–177 (2024). https://doi.org/10.1007/s40477-023-00822-3

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  • DOI: https://doi.org/10.1007/s40477-023-00822-3

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