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Velamentous insertion of the umbilical cord - Page 3

post #41 of 93
Wow, JavaFinch. I'm amazed (and so happy) that you pretty much diagnosed yourself. There needs to be more education on Vasa Previa. It is a rare condition, but not so rare that it does not warrant screening for.

We had Vasa Previa too. I was undiagnosed and I woke up to heavy bleeding one morning (at 36 weeks). We called an ambulance and at the hospital a placental abruption was suspected. During the c-section, they discovered VCI and a succenturiate lobe--and there was no blood in the cord. They got my daughter out just in time. A small fetal vessel had torn and she lost almost half her blood. She had a terrifying NICU stay, but is a thriving 21 month old today with only some very minor developmental delays.

I had none of the risk factors for VP except a low-lying placenta (detected during my 20 week u/s).

I have a copy of my hospital records. That time was such a blur and I needed some answers. I also spoke to the OB who performed my surgery. But I completely understand not wanting to dwell on it. The what-if game is horrifying.

Vancouver Mommy, I'm glad everything turned out okay (relatively speaking, of course- not emotionally, I know). I'm very sorry about your birth experience.
post #42 of 93
Hello,

I had identical twins, unassisted at home, double footling breech each (I will post their birth story or you can read it here nearly 2 years ago.

The first born, Faith, had a perfect cord insertion, dead center of her placenta and everything. The second, smaller twin, Crismas, had a velamentous insertion. Based on their positions as they were coming out,it would be my educated guess thier breech presentation was directly related to preventing vasa previa.

here is a pic
http://i22.photobucket.com/albums/b3...entouscord.jpg

Crissie has some issues. She has narrow drainage vessels in her head (gives her a chance to develop hydrocephalus - water on the brain) and her heart. She has not required any type of surgery for these conditions and seems to be outgrowing them. She gets hypoglycemia (low blood sugar) the timing varies depending on what she eats. She was born at 35 weeks weighing in at a whopping 3 pounds 10 ounces (Faith was 5 pounds 5 oz). She was also very short, basically the size of a 32 weeker.

There is another type of insertion, too. A Marginal Cord Insertion where the cord is in the placenta, but it is at the edge of the placenta. This is pretty much a normal finding as most cords don't seem to be found in the exact center (according to my research).

The velamentous insertion in twins seems to be directly related to Twin to Twin Transfusion Syndrome (TTTS). It isn't the only cause of it, but tends to be quite common in the condition. It also tends to be only seen in identical twins, monochorionic diamniotic membranes. In case you are not familiar with those words, there are actually 2 membranes covering the baby and holding the water. the amnion is the innermost membrane and the chorion is the outer most membrane. mono means 1 and di means 2. it means each baby has their own water bag with the outer layer covering both.

In my research, I found that velamentous cord insertion statistics state 1% of singleton and 8% of multiples. It seems to develop between 6 and 8 weeks, around the same time as heart and spinal fluid vessels do.

It is a scary situation to come across. Trust me, after I saw her cord I had to google it right away. I also looked in an old William's Obstetrics Text from 1910 and found information on it there. As I was readdng the different things that can be caused, my eyes were bugging out of my head.

I was so thankful, vindicated and empowered that I chose to have them (though undiagnosed) safey at home. The alternatives scare me more than a funky cord insertion. I *could* say it makes a great case for going UC, but I truly say it simply makes a great case for minimizing intervention in and after the birth of a child.
post #43 of 93
I would say my own story makes a terrible case for going UC - my DD would most likely have died.
post #44 of 93
Quote:
Originally Posted by JavaFinch View Post
I would say my own story makes a terrible case for going UC - my DD would most likely have died.
that very well could be true. It just goes to show that for every woman, following her instincts about the baby and everything relating to it is really the most important aspect of prenatal care, whether it be formal or not.

I have read many stories from moms, similar to yours, IVF not necessarily similar, that the mom had to do just what you did and push for tests and such which ended up saving the baby's life.

Great for you and your little one that you went with your gut and pushed them all until you were sure your little one would be safe.
post #45 of 93
I have a miracle story to tell everyone. I was 37 weeks along in my pregnancy when one night I got up and noticed alot of blood, this was my first baby and I knew this was not right, so my husband and I went on to the hospital, we were there about 4 hours and everything was going fine, then all the sudden my son had no vitals, they rushed me in and did a c section, he was born and I don't remember much, they rushed him into nicu and worked on him for about 2 hours, the doctor at that point came in and said they had to transfer him to the university childrens hospital that they could not help him enough at this hospital. so we did. As soon as he got to the nicu at the University of Kentucky childrens hospital he was placed on ice and cooled for 72 hours to prevent anymore damage, at this point he had liver and kidney damage. after 72 hours they started warming him up slowly and giving him milk through a feeding tube, his stomach blew up and the doctors found a hole in his stomach, and he had to have emergency surgery to repair his stomach at 3 days old. we were in the nicu for 2 long weeks that was suppose to have been longer. with lots of prayers and knowlegable doctors he has recoved fully, he is called the miracle baby at the UK childrens hospital. we are so fortunate to have him and the ice program is a big factor in his health and it had only came out 2 weeks before he was born and he was the first baby to do the study at this hospital. Thanks god for the advancement in medicine. My sons is a normal 14 month old baby and is doing alot of advance things for his age. we are blessed!
post #46 of 93
Lanes mom, wow, what a story! That sounds like it was so scary for you, but I'm glad everything turned out good for your son!
post #47 of 93
I recently lost my little girl to velamentous cord insertion. I had a perfect pregnancy an there was no sign of any problems ( because noone picked it up on my 20 week scan because they dont look for it). but when i started to have contractions it put strain on on of the vessels and one rupured an this is is when they found out there was a problems because i started bleeding and they couldnt find a heartbeat, but it came back but not very strong an i was given an emergency c-section. Nicole died from fetal blood loose just an hour an 10mins old. R.I.P Nicole mummy and Daddy love you and miss you every day
post #48 of 93
I'm so sorry for your loss, blondey88! What a beautiful name, Nicole. I'm sure she was a beautiful baby.
post #49 of 93
Blondey88 I am very sorry for your loss.
post #50 of 93
blondey88- I'm so terribly sorry.
post #51 of 93
Blondey88 - I'm so sorry for your loss. My precious DS died in August 12 hours after his birth because of undiagnosed VCI and vasa previa. He also underwent hypothermia treatment like Lanes Mom's son, but he had suffered too much damage from the loss of blood. He was resuscitated a number of times before we could get from my birth hospital to the children's hospital (he was transferred). At that point we knew there was nothing we could do for him except hold him as he passed away.

It has got to rank up there as one of the most preventable causes of death in newborns. From the studies I've found it can be diagnosed 100% of the time if the ultrasound tech/doc will just look for it. As JavaFinch's story illustrates - too many professionals just don't know what they're looking at. It is all in education.

I would give just about anything to have known ahead of time the words velamentous or vasa previa. I had a low lying placenta but it cleared up and I was given the go ahead for a vaginal delivery. If I had know what to ask them to look for I would have. It is a shame that mom's have to educate themselves on these types of issues.

If you have any risk factors do just like JavaFinch - insist on knowing. As the vasa previa foundation so aptly says "it only takes a minute to diagnose life."

If your doc doesn't know what to look for send them to vasaprevia.com. The Foundation has a quick training slide show that will educate docs/techs what to look for on an ultrasound.

Congrats to those whose children survived. They are your miracle babies and hug them tight!
post #52 of 93
First, I am so sorry to those who have lost a child to this

One of my twins (they are identical but were dichorionic/diamniotic) had valementous insertion. Both of the boys amniotic sacs were very, very thick which I think really helped prevent a problem with this. My 1st twin was born in his sac and the mw cut it open after his birth and my 2nd twin's (who had vci) sac did not break on it's own. His head was out but his shoulders were not coming out (we think his hand was up on his shoulder) so she cut his bag (it was so thick she actually had to use scissors) and then he was born. I am so thankful that she did not cut through anything. I had no idea this was such a thing and my mw had never seen it before either. My mw actually ended up having a mom a few weeks after me have it also and she also had a great home birth with no problems at all.

Also, I have plenty of u/s's throughout my pregnancy and they never caught it.

Here is a pic of it, it is pretty cool looking!
http://i46.photobucket.com/albums/f1...miller/538.jpg
post #53 of 93

Vic

Hi all. I enjoyed reading all of your stories. My heart broke as I sobbed through some and yet I felt hopeful as I read others. Part of me wishes I didn't know and perhaps I could have a miracle birth and miracle baby like others so joyfully did, yet part of me is happy that I am finding out and could avoid the pain and suffering so many have felt from their loss.

What I don't understand is how a c-section can save a baby that has velamentous insertion of cord with vesa previa? When they cut you, don't they have to break the membranes to get to the baby? so, doesn't the baby bleed out anyway? I'm just confused because when your water breaks it seems like those veins that were streaming across the membranes of the placenta cause the babe to bleed out, yet when they cut you open to get the baby out of you won't the membranes be ruptured or cut anyway? Or do they clamp the cord or something before?

Just really confused on how it will all work. I go for my 21 week ultrasound next Thursday where they will use a color doppler to see if it definitely is vesa previa and/or the membranes are streaming across the placenta or not. They will also be able to see how the organs are doing, heartbeat, blood flow from the cord to the baby, etc (I think).

When they looked at her at 13 weeks, they noticed a bulge in my placenta (like a cyst on it), then at my 17 week US they saw that the cord was inserted right next to that "bulge" and saw it was velamentous insertion. I of course googled right away and the one thing that stuck out to me was scheduled C - section

I had a Bradley Birth with my daughter, Sylvia. Simply amazing. My midwife was awesome, we breastfed for an hour she was alert and I just remember looking into her eyes and feeling so blessed. As my husband was leaning over my shoulder, he said WOW! in complete amazement at this miracle we just witnessed, and she completely turned her head to look at him as if to say, Oh that's what you look like! Just so memorable and such a desirable birth to do all over again.

Since the diagnoses, I've been dwelling, pondering and sobbing about the possibilty of a scheduled C-section. I just need to hear more about how the c-section went for anyone that knew ahead of time and planned it and how it went. Were you able to room in with baby? Were you able to breastfeed immediately? How did you feel after having so many drugs in you? I'm just really curious/concerned and want to know what to expect. Do all babies with VIC have complications that require NICU?

Thanks for tips moms, I'm really blessed by all of your champion stories.
post #54 of 93
Jostaint, congrats on your pregnancy! I will try to answer your questions, and sorry if I repeat anything (I didn't re-read my old post).

I am not sure if there are situations where a doctor would need to cut through the placenta, but my placenta was posterior, so there was nothing there on the front of it where they cut in, so no vessels were cut. The vessels were around the cervix, not the front of the uterus. Even if they do have to cut through the placenta (I'm unsure if that is something they do), that would be seconds to clamp the cord, so not very much bleeding would occur. Even so, they would take some blood from the cord/placenta to give to the baby if her levels are low. MUCH better than bleeding happening when the mom is 30 minutes away from incision.

I tried to get pregnant for a very long time for DD, so that may have clouded my experience of her birth, but here is my experience. I at first wanted a natural birth, of course. I wanted to do delayed cord clamping, I didn't want them taking my baby away to the warmer for a long time - all the stuff most moms on this site would want I was holding out hope right up to the day they sent me up to the hospital when I was finally diagnosed at 35 weeks that I'd get the 'all clear' for a vaginal birth. But no, c-section it was.

I LOVE the hospital I delivered at. I loved my doctor. Except for one nurse (lol), I loved all the nurses. Even though I wouldn't have chose the c-section and I was scared, it went great. DD was 35 weeks - I had 2 steroid shots prior to her birth and she came right back to me in the recovery room (before they had even put me back in my room - within about 30 minutes). I held and nursed her right away. She nursed GREAT - I had absolutely zero nursing problems with her. She roomed in 100% of the time I was there. I had no problems with the c-section and even spent my first day home from the hospital cleaning my house (it had gotten out of control from my bedrest and week in the hospital) - and I stopped taking my painkillers on Day 3 while still in the hospital. My milk came in on Day 3 - I did request a pump and pumped to try to get it to come in because I was paranoid about that (I even ordered 8 oz of donor breast milk to be prepared in case of low blood sugar, which never happened, and I ended up not needing it).

I look back on the time with much , just like my son's birth (vaginal) - they were different experiences, and while I wouldn't have WISHED for DD's issues, I felt so lucky to have it all turn out the way it did. Also, DD had a true knot and some other issues with her placenta. I just had just a relief to just get her OUT.

I was worried about her immunity being lower due to not being in the womb the last month. Not saying it's not better to be in the womb, but DD has been very healthy. She just got her first snotty nose (no other symptoms) last week and her first birthday is tomorrow. I got a cold before Christmas, and she never got it.

Good luck - I hope you get your vaginal birth, but if not, the important thing is all the comes AFTER birth, anyway.
post #55 of 93

VCI and premature birth

I know this thread is old but it has been revived several times so thought I'd post.
I had my DD at home in water birth with midwife support, at 37, knot in her cord but no concerns. At 41 went for amnio on my 2nd child, they discovered VCI. Midwife said it was no concern, no biggie, they don't usually see it until after the birth - far too casual attitude for me so switched back to my family doctor for care. The local high risk clinic said they wouldn't see me as it wasn't high risk. I KNEW things weren't quite right, had my bags packed the week before i went into labour. My DS was born through precipitous birth following rupture of membranes at 32 weeks. His HB went up and down throughout the birth - an OB came in eventually and discovered he was Frank Breech. Born vaginally, then I had a retained placenta, so I also got to experience the hand in the uterus manual placenta retreival.
My son was sent to NICU after developing NEC (preemie infection of intestines) but survived that too.
It's been a frightful year - he's now 14 months. A very happy wonderful little boy who has developmental delays. We think possibly cerebral palsy although the neurologist said it isn't. He sits now (started at about 11 mths), and can roll, and has begun propping up on his hands when on tummy. Can kick his legs and LOVES to do so when on back, but is quite spastic at times and definitely has motor delays below waist for sure, as well as verbal.
I think the VCI and drop in heartrate throughout the birth probably are associated with his delays.
He's had one health concern after another, and we haven't considered any legal action - but I am wondering if his delays could have been avoided if that high risk clinic had listened to me.
post #56 of 93
This thread has been really helpful for me. I just had an u/s at 8 weeks and have a suspected VCI. I will be monitored more closely and go back for another scan in 2 weeks and also have an appointment with the MFM docs.
post #57 of 93

I am really curious, i delivered my son at 41+1 weeks when he was delivered i was told i had a velamentous (choriamniotic membrane). My son and i went home the next day only for him to be readmitted and transferred to a children's hospital due to seizures. Does this vci have anything to do with his seizures.

post #58 of 93

I have identical twins and both shared one placenta and shared 1 amniotic sac (happens about 1% in identical twins).  They also both also

were velamentous insertion of the cord which was very dangerous as they did not have the strong attachment to my placenta but hung

from veins in the side walls of my sac that then went up to my placenta.  At birth the first twin had the second twins cord around his

neck which pulled my second twins umbilical cord loose from me.  He was detached from me and we  both were hemoraging.  The

doctor had to manually pull out my placenta to stop the bleeding.  He told me in his 40 years of delivering babies he had never seen

both twins with the velamentous insertion.  Thank goodness I delivered the babies 2 minutes apart or the second twin and myself would

have died.

post #59 of 93

Wow, I didn't know VCI had so many sad outcomes :( I had VCI with my son. I had a very smooth, healthy pregnancy, had 2 ultrasounds but the VCI wasn't diagnosed until after birth. I was 39 weeks. I was in labor for 13 hours and my water was accidently broken when a resident checked to see how centimeters dialated I was. Toward the end of labor my OB told me he was going to have the OR prepped in case I needed a c-section because my baby was distressed. Early the next morning, I was 8 centimeters dialated, when all of a sudden my OB and a bunch of nurses ran into the room and started wheeling me to the OR saying I needed to have an emergency c-section. Everything was a blurr and all I remember is they said something about his heart rate being way too low and he wasn't getting any oxygen. I didn't ask questions though. I was 17 and scared to death. Everything happened in matter of minutes and then my son was born. He was 5lbs. 12oz. and perfectly healthy. Later, my OB told me about my VCI. He said is was very rare and that I was his 2nd patient to have it in his 30 years of practice. After reading so many horrible outcomes of VCI, I thank the Lord that my son is alive and healthy. He will be 2 years old March 2nd.

 

I do have one question though. What are the chances of VCI recurring in the next pregnancy?

post #60 of 93

well I am gob smacked.  Not once in my 11 years of practice as a midwife have i had a velamentous insertion cause a problem.  I've heard of vasa praevia, but never seen it aamong the woman i have cared for.  I have had one situation in which a baby had fetal distress and a crash lscs, after which it ws discovered that baby had free floating vessels within the amniotic fluid, sort loops of blood vessles.  That was scarey.  The examples of velamantous insertion i have observed, and there have been plenty, have been only picked up after the birth of the placenta.  i usually get quite excited and show any students if they are around.  Mind you, i don't rupture membranes routinely, and certainly not until i've had a good feel to see it there are any pulsating vessels present!!  My deepest sympanies to the posters who have lost babies.  I have certainly learnt something

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