Battledore/marginal cord insertion

[crazykittymomma]

I'm 10 weeks pregnant with my second child and at my midwife appointment today we reviewed the medical records from my last birth (horribly traumatic birth center transfer for raised bp in early labor turned fetal distress emergency c-section) and my midwife thinks the reason behind my daughter's distress was that I had battledore/marginal cord insertion which is where the cord is attached to the side of the placenta rather than the center...she indicated that in an out of hospital setting the problem could have been solved with changing position, etc and that it wasn't something I should worry about...but, I'm a worrier so...here are my questions-

Has anyone had a totally natural birth with battledore/marginal cord insertion?

Has anyone had an abnormal cord insertion with one pregnancy and then again with another? Is it a one time deal?

Is there any reason that my first midwife wouldn't have known (I had one u/s at 18 weeks with her) or wouldn't have told me (granted, she also didn't bother telling me that I had low fluid or hypoglycemia...)?

Is there any reason that this type of problem would contribute to a "window" rupture of the uterus? Apparently, that was in my records too, though no one ever mentioned it to me in the hospital.

I'm aiming for an HBAC this time around, so I just want to know everything I possibly can about what happened before.

[Italiamom]

Originally Posted by crazykittymomma 

Has anyone had a totally natural birth with battledore/marginal cord insertion?

Yup, me.  Natural, out of hospital, very wonderful birth!
 

Originally Posted by crazykittymomma 

Has anyone had an abnormal cord insertion with one pregnancy and then again with another? Is it a one time deal?

From what I understand, it's a pretty rare thing, and the likelihood of it happening twice is REALLY unlikely!  It's not based on genetics, or something that would be reoccurring...  It's just a freak accident in cord formation.

Originally Posted by crazykittymomma 

Is there any reason that my first midwife wouldn't have known (I had one u/s at 18 weeks with her) or wouldn't have told me (granted, she also didn't bother telling me that I had low fluid or hypoglycemia...)?

A battle door insertion is a little different than a velamentous insertion.  It's not really all that serious, you just want to avoid cord traction.  It's possible that the ultrasound tech missed it, or your midwife missed it in the us notes, or just that your midwife didn't think it was a big deal.  It would be hard to know without asking her.

Originally Posted by crazykittymomma 

Is there any reason that this type of problem would contribute to a "window" rupture of the uterus? Apparently, that was in my records too, though no one ever mentioned it to me in the hospital.

I can't imagine that an insertion would in ANY way be connected to the uterus really.  I think that the dangers in cord insertion lie in A) the "compromised" portion of the cord being compressed or breaking while baby is still in utero, or B) the "compromised" portion of the cord breaking before the delivery of the placenta (meaning that mom can lose more blood).  But those risks would be associated with a velamentous insertion, not really a battledoor insertion.  And those would have nothing to do with uterine rupture!

Again, for that particular cord anomaly to happen twice would be pretty rare.  It's not genetics, it's not really based on something you did or did not do (although apparently they are slightly more common among women who smoke).  I would make sure that they check at the ultrasound, but I would NOT worry about it.

And in my own experience, we knew about it ahead of time, and it in no way affected my natural birth.  My midwife was careful to avoid cord traction after delivery, but that was it.  And I think she probably does that anyway...

[kawa kamuri]

My last and current placenta have marginally inserted cords. My most recent birth was glorious and natural with no complications. My MWs are not worried, no one ever was. I've been told it's a variation of normal, nothing more. 

[crazykittymomma]

Thank you for the input! I'm feeling much better about it! All the mainstream stuff I read about it freaked me out. Now I just have to research the window rupture thing.

[kawa kamuri]

FWIW the ultrasounds with both of those pregnancies took place at the office of a large, conservative OBGYN practice. None of those doctors even blinked at the way the cords were inserted into the placentas. That's normal, they said. I happen to think placentas with marginal cord insertions are incredibly beautiful! 

[Italiamom]

Originally Posted by kawa kamuri 

FWIW the ultrasounds with both of those pregnancies took place at the office of a large, conservative OBGYN practice. None of those doctors even blinked at the way the cords were inserted into the placentas. That's normal, they said.

Agreed.  I got a regular US first, where they diagnosed it as a battledoor/slight velamentous insertion.  And then I went home and got on the internet and got FREAKED out.  So my midwife had me go to a perinatalogist for a high level ultrasound, and just like kawa kamuri said, they didn't even blink.  The perinatalogist told me the same thing my midwife did -- that it was nothing to be concerned about, and that it would only affect possible cord traction during delivery of the placenta.

[Full Heart]

Originally Posted by crazykittymomma 

I'm 10 weeks pregnant with my second child and at my midwife appointment today we reviewed the medical records from my last birth (horribly traumatic birth center transfer for raised bp in early labor turned fetal distress emergency c-section) and my midwife thinks the reason behind my daughter's distress was that I had battledore/marginal cord insertion which is where the cord is attached to the side of the placenta rather than the center...she indicated that in an out of hospital setting the problem could have been solved with changing position, etc and that it wasn't something I should worry about...but, I'm a worrier so...here are my questions-

Has anyone had a totally natural birth with battledore/marginal cord insertion?

Has anyone had an abnormal cord insertion with one pregnancy and then again with another? Is it a one time deal?

Is there any reason that my first midwife wouldn't have known (I had one u/s at 18 weeks with her) or wouldn't have told me (granted, she also didn't bother telling me that I had low fluid or hypoglycemia...)?

Is there any reason that this type of problem would contribute to a "window" rupture of the uterus? Apparently, that was in my records too, though no one ever mentioned it to me in the hospital.

I'm aiming for an HBAC this time around, so I just want to know everything I possibly can about what happened before.

I had battledore/marginal cord insertion with my 3rd.  Had a totally natural 2.5 hour labor and successful homebirth of a 9 lb baby 16 days past my edd. I had 2 u/s while pg and it was either never detected or never told to me or my mw (she def did not know).   And the 2nd us was a week before delivery.  I never had another like that and I have had 6 more children.

[crazykittymomma]

Good to know! Thanks!