I was just diagnosed today (at 31w4d) with a succenturiate placenta (main part is anterior & the accessory lobe is posterior) with a probable velamentous insertion. The perinatologist used color doppler & looked around for a long time but still wasn't able to fully see the insertion to confirm it is velamentous, but it looks like it occurs in between the lobes; I also recall the tech at my 20wk u/s saying offhand that I had a velamentous insertion. This is all at the very top of my uterus. I am not sure how concerned I should be. I am mostly worried about the potential for a missed vasa previa. I am not sure if that's even a possibility - could there be unprotected vessels hiding down low when everything else is up high? A transvaginal ultrasound was not done, though the doctor definitely looked down by my cervix. Complicating everything, I have a cervical polyp that has caused bleeding throughout the pregnancy. That would make a transvaginal u/s problematic, as it would almost certainly cause bleeding. And now, whenever I have bleeding, it will be hard not to worry that it's a ruptured vessel.
I am being seen for my regular care at a freestanding birth center, but now I may be risked out to the hospital where the midwives can deliver, and even if I'm not, I am feeling wary of delivering out of the hospital, especially if I can avoid many of the unnecessary interventions but be in the hospital.