Velamentous insertion of the umbilical cord - Page 4

[Blesssed]

I have found the reading of these post very interesting.  I just gave birth to a 9lb infant with velamentous insertion.  I had him at home and my husband caught him because he came before the the midwife could arrive.  Baby was fine and all seemed well till the delivery of the placenta.  I am praising God that I am still here as the cord became unattachted from the placenta and we could not get the placenta out.  After trying pushing, pitocin, forcepts and a lot of uncomfortable procedures we headed to the hospital.  However, the local hopspital didn't want to take me so we had to drive, i was stable at the time but in route began bleeding again, ended up in an ambulance at emergency care with great blood loss.  The paramedics and OB team were great though and I am thankful for a Dr. with small hands : ).  At the hospital they were able to remove the placenta w/o a D&C and I am recovering at home.  I am thankful for the opportunity to have my 2nd home birth, and thankful for the cooppoartion of the hospital and staff to help when we couldn't handle at home. 

I hope that people will realize that home birth is safe (my first was at home and went beautifully)  but it is great to work together with a hospital for back up when things get serious.  I am thankful to all that played a part in the birth and recovery of my child.  Had I not been rejected by the local hopsital I don't think I would have ended up with such a dangerous situation.  VI seems to be easily worked through with the proper care, wether home or at the hospital.

The VI I had was not known to us before the birth, though it had been picked up via ultrasound.  Good communication between caregivers is important.  We are not sure why this wasn't caught before the birth but again, I am thankful that my baby and I are ok and it was so special for my husband to deliver.

So very Blessed

[NYC_CNM]

I just gave birth on 5/16/11 and we had a VCI as well.  It was a successful homebirth, I am going to post his birth story to this forum now so everyone can read it, as well as a picture of his placenta (hope that's not too graphic for everyone)!  It was a wonderful, amazing, empowering birth, and every time we listened to the baby's heart rate (which was done frequently) his heart rate was always strong and steady, with no decels or indications of distress.  My membranes also ruptured spontaneously when I was anterior lip, and thankfully there was no vasa previa, only the velamentous cord.  We had no idea about the VCI (this isn't seen on sonogram very often) and had we known, I probably wouldn't have planned a homebirth.  But my birth was such that I think DS got exactly the birth he needed, especially given the fragile nature of his cord.  Anyway, I will post his story under a separate thread.  I am glad all went well with you and your birth too!  We feel extremely lucky and blessed that, and that our DS was meant to be here with us in this world.

[txmomto2]

So thankful that I found all of this information and these birth stories.  I am pregnant with my second son and found out at my 18 week sono that he has VCI.  All my Dr told me was that he had VCI with a brief explanation of what it was and directions to go straight to the hospital if my water breaks.  I'm thinking Great, I live 45 minutes away without traffic.  Anyways now I am loaded with questions to ask at my next appointment.  I had a color doppler but unfortunantly the tech did not even mention anything about it so I have no clue where the placenta is located in relation to the cord insertion site.  I am going to ask about vasa previa and where everything is located.  I had an emergent c-sec with my first son after being induced at 37 weeks due to polyhydraminous but my Dr seems perfectly fine with letting me try for a VBAC.  Does anybody know of any other questions I should be asking?  I had the ultrasound tech at my hospital take a look and the placenta is anterior. He did the color doppler and it shows a three vessel cord closer to the baby but then it goes to a two vessel. He was not able to tell where the other one was located but the two he could see were inserted into the membranes, not the placenta. This person is also not trained in complete OB sonos and said he really wasn't sure.  Should I request to be seen by a specialist or trust my Drs opinion and just wait for another sonogram closer to delivery?

[mngrammy]

Our granddaughter had VCI and if our daughter hadn't switched to midwives mid pregnancy, our granddaughter wouldn't be here today.  Our daughter started with OBGYN's, they based her due date by the size of the baby, not the dates, so had her due date 1 month after she felt she was due.  I strongly encouraged her to find a good midwife, someone that would listen to her.  Our daughter made the switch and the group of midwives were amazing.  I can't even begin to tell you how grateful I am to midwifery!  

[Jaimep]

txmomto2 - I would definitely make sure that no one breaks your water for you. If they try to they could hook the cord on accident and your baby could bleed to death. Not trying to be scary, but it is a scary thing (the water breaking part). Other than that if you go into labor on your own and your water breaks naturally it should be fine.

It is awesome that your OB is fine with it. That is really good news. Definitely if you are seeing any blood in labor you need to get to the hospital ASAP. But that is the case with all birth right? ;)

I also agree with previous posters that I think its important to not push only when your body is telling you to and in a comfortable position. I know that is hard to get at the hospital some times but I think the less stress on the baby and the cord is best. We had a homebirth with our VCI baby and I only pushed a few times and he was born.

[txmomto2]

Thanks Jaimep, will do for sure. Knowledge is my power and I am much more afraid of not knowing then knowing. The hospital I will deliver at is also the one I work at so I have no problem bullying a nurse or my dr for that matter to get what I want. A midwife is not in the budget and I like my dr, he was my mom's ob when she was pregnant with me.  I went for another ultrasound, the one at 18 weeks he measured a week ahead and now he measures a week behind.  I wonder if that is normal this early or if the cord is being compressed?  I also purchased a fetal heartrate monitor for my piece of mind.  Will update as things progress.

[Jaimep]

In my experience (I am preg. with #4) ultrasounds are not so accurate all the time. Measuring a week ahead or behind doesn't really mean much. Now if they are monitoring you and baby consistently is measuring smaller or no growth those are things to worry about. You could do some yoga inversions and excercises to move baby around. I imagine you have plenty of room so cord compression is not likely this early.

My VI baby was only 6 lbs 7 oz. My first two births were 8lb and 8lb 3 oz.  So we wondered if size had to do with the VIC. Now at 3 years old we can say that he is just built like me tall and skinny. I was only 6 7 at birth as well. He is still petite.

[SaraDani21]

I gave birth to my daughter back in Feb. of 2009. I had her with a VCI. Like Tattoomom from 2007, my labor was induced with pitocin and they ruptured my membranes several hours before my daughters heart rate started dropping due to the fact that I wasn't breathing after my contractions. I was fully dilated and 8 cm and hadn't progressed in 12 hours. Finally I was forced to have an epidural (which I had been avoiding). About 3 hours after the epidural my daughter was born. There were no complications during the actual birth, except a little more blood loss than my midwife would've liked. When I pushed my placenta out, the attending made a comment on how it was odd and my midwife gave him a scowl. My husband asked about it, but they just responded with there could've been complications, but there weren't. When I went back a month after my daughter was born, I asked about it and they said, "Oh, you're the one!". How likely is this to happen again? I've heard that it's detectable, should I try a different caregiver for my next child because they didn't notice?

[Jaimep]

SaraDani21,

From all the reading and research I have done on this no, it should not happen again. The statisics say that it only happens in 1% of singleton births. So the fact that it happened to you at all is RARE. you have a 99% chance it won't happen again.  ALso from what I have read is that Ultrasounds only pick it up in about 50% of cases. Of course if you wanted them to specifically look for it then they would have a better chance of finding it. However, if they do find it be aware that they would recommend a C-section.

Having had a baby with this and a normal birth/healthy child you know that a c-section is not necessary. I know the same thing because I had a healthy son too. We are also pregnant again and have chosen not to have an ultrasound. We don't want to know sex and I am honestly not worried about the VCI happening again since it is so rare to start with.

I know we are also lucky because we are the good birth stories and there are sad ones here. SO I am not dismissing these other mama's feelings about it. I am sure they would tell you to get the Ultrasound. You will have to do what you feel is right in that regard.

[Cheshire]

After losing my son to VCI we decided with our next pregnancy to find an OB and a perinatologist to work with us to make sure it didn't happen again.  We knew it would be rare for it to happen again but then again losing our son to it was supposed to have been rare.  When your the 1%, odds don't matter anymore.

http://www.preginst.com/UmbilicalCordAccidents2.pdf      Read page 31 especially for detecting and managing.

Umbilical cord accidents are more common than most suspect.  With my first son I had a battledore insertion (marginal insertion).  Everyone said it was incidental and interesting.  Shouldn't happen again.  Well, they were right.  The next time it was even worse with a velamentous insertion.

For us, gathering as much info as we could with our third pregnancy helped us sleep better at night.  As Jaimep said, you have to do what you feel is right. 

[TrumpetMom]

So contrary to what some people on a different forum site are suggesting, I'm not totally crazy continuing my plans for an HBA2C with VCI? We've prayed about our decision and feel at peace, but I'm getting distressed that people are going to think I'm evil or something if something bad does happen. My gut feel is that everything will be fine. I do not have VP, only VCI. At 28 weeks the perinatalogist said it is 2cm from the cervix and my midwife is of the opinion that things will continue to move up and away. The peri also told me that VP (with vessels actually crossing the cervix) cannot happen at this point because the vessels won't grow any more.

I really appreciate all of the stories, with both positive and negative outcomes. Both are very enlightening; much to think about. I hope you'll all understand if I'm really latching on to the postive outcome stories, since I hope to be one of them. My heart goes out to all of you who have lost a child to these conditions (both VP and VCI), or had complications as a result. For those of you who had a c/s (planned or emergent) or any other complicationdue to the condition, I pray for complete healing both physically and emotionally for you.

Thank you all for this thread, regardless of how long ago it was started. The information here is invaluable for moms who are looking for information and encouragement in making the right decision for theor families.

[Jaimep]

You are most definitely not crazy. Its seems you are doing the best of both worlds, planning a homebirth but getting monitored with a ultrasound and such to see the progress. I personally feel that the low interventions that occur with homebirth give the best chances of everything going smoothly. But like you said, I say this as a previous success story. I know others feel differently and I am sad for them and their loss or problems.

We are planning our second homebirth anyday now and I am really excited.

Good luck and please share here how it goes and what you ultimately end up doing!

[bignerpie]

I just had an HBAC, and we didn't know that I had a VCI until I delivered the placenta. I don't know if I also had VP. My midwife did not mention it, so I'm assuming not. The only issue that I had was that the umbilical cord was extremely short. I had to hold my baby pretty much between my legs until we cut the cord. I did have a 20 week ultrasound, but there was no mention of any cord issues.

My entire labor was 2 hours, 50 minutes, and my water broke on its own, so it was a very fast, easy labor. I'm kind of freaked out now, thinking about the what ifs. But at the same time, I feel very fortunate to have had such a great experience and no issues relating to the VCI.

[Mandi2214]

Thanks so much for the information!!!

I just had my ultra sound to determine the sex and any abnormalities. The doc says I have velamentous insertion and wants to see me once a month to make sure the baby is growing properly I'm right about 20 weeks. I will go next month to see if any vessels cross my cervix but she said he looks great so far no issues.

Thanks again

[Mandi2214]

Thanks so much for the information!!!

I just had my ultra sound to determine the sex and any abnormalities. The doc says I have velamentous insertion and wants to see me once a month to make sure the baby is growing properly I'm right about 20 weeks. I will go next month to see if any vessels cross my cervix but she said he looks great so far no issues.

Thanks again

[Mandi2214]

Thanks so much for the information!!!

I just had my ultra sound to determine the sex and any abnormalities. The doc says I have velamentous insertion and wants to see me once a month to make sure the baby is growing properly I'm right about 20 weeks. I will go next month to see if any vessels cross my cervix but she said he looks great so far no issues.

Thanks again

[marrymeflyfree]

I'd like to add another positive story...my first baby had an undiagnosed VCI despite the routine 20 week ultrasound.  At 20 days past her due date and with a very tiny fluid leak, I took castor oil at the freestanding birth center.  She was born 6 hours later with several large hematomas on her cord.  I'm still not exactly sure what happened with the delivery of the placenta, but it was a bit dramatic for a little while.  I *think* she started to pull on the cord, and I think that's when my bleeding started worrying her.  In the end, the placenta was delivered and my bleeding controlled without the need for transfer, and examination of the placenta very clearly showed the abnormal insertion.  The baby was 8lbs 13oz, and is now a happy and precocious 3.5 year old!  We had no warning of the VCI, and honestly I did not know for quite some time after her birth how lucky we were.

[theogeo]

Another homebirther here. We didn't know about the VCI until the placenta came out (without much fuss, just a little cord traction). We did, however, know we had a single umbilical artery, discovered at our 18-week ultrasound. I saw a perinatologist but given the placement of the placenta and how normally everything else was progressing, we proceeded with our homebirth plans. I delivered at 39 weeks, 2 days. Water broke early in the morning on Friday and I went into full-blown labor that night at midnight. The baby handled labor like a champ and eight hours later (fast labor for a first-timer!) my midwife inspected the placenta and said she'd never seen anything quite like it. 

Other than the baby being somewhat smaller than I expected -- 7.5 pounds; I was expecting a BIG boy! -- he was and is in perfect health. I am so grateful for the wonderful outcome given all the variables involved.

Thanks for sharing your stories, everyone.

[JemMace]

This is the confirmation I needed - I lost my baby girl at 36+4 (still born) with no explanation from the doctors. I was simply told it was "one of those things" I lost my baby in September 2012 and I'm currently 25weeks pregnant so I'm pretty anxious as you can imagine. I could not bear the thought of the same thing happening again so I'm trying to get answers to avoid this same tragedy happening... After reading about "velamentous cord insertion" the similaries to what I experienced make me believe this is hat happened although that was never confirmed by the hospital (poss to hide the fact they messed up big time by not identifying this with routine scans) I noticed baby was moving quite a lot more than usual, I had pains through the night followed by my plug show the following morning, was told by the hospital to keep an eye on the pains and if anything was to change then ring back, that day I felt normal baby movements and the same pains that following night, in the morning the pains had stopped and I hadn't felt any baby movements, my M/W came to see me and could find a heartbreat and sent me to be hospital where they confirmed they couldn't detect baby's heartbeat. Later that night my waters broke and I went into natural labour, baby was born a healthy weight of 6lb2oz considering she would have been over 3week early. I was then unable to deliver my placenta and had to have this manually removed jus like you - I'm almost 100% this is the condition I must have had. Thankfully I'm having fortnightly scans and colour dopplers are being used but I'm certainly going to be asking more questions since reading these post.
Thanks for all the information shared

[viking girl]

I also was diagnosed with VCI but not until after the birth of my son. It had in my case caused chronic abruption of my placenta and at barely 32 weeks of gestation it then caused a full abruption. my son was delivered with emergency C-section and I thank god that we were already at the hospital because of the previous episodes of bleeding. My OB was incredible and acted faster than anything I have ever heard of and that saved both of us. Have anyone experienced a relation between VCI and placenta abruptae?