umbilical cord quesion - marginal insertion - Mothering Forums

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#1 of 8 Old 09-05-2009, 12:25 PM - Thread Starter
 
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Hi everyone. I just had my 20 week anatomy scan (actually 19 week) and on the way out the doctor mentioned that the cord was attactched to the very end of the placenta and that we will need to come back every 6-8 weeks to monitor the baby's growth.

I really felt strongly about having only one ultrasound in pregnancy, and so i'm not sure how I feel about this. I guess I am just trying to figure out how important the extra ultrasounds will be. I did a little research online and I am pretty sure what I have is the "marginal inserted umbilical cord" which occurs in about 5-7 percent of pregnancies. She said that most of the babies do fine but it can potentially affect their growth so should be monitored.

My plan had been to switch over to a homebirth midwife sometime after the ultrasound (if everything was normal) so I'm not sure how this will affect my decision. I was wondering if any of you have experienced this and can offer any insight. I am wondering if the midwife would just be able to feel the baby's growth without ultrasound and then if she suspects anything we could go for another ultrasound. Also, does anyone know about the treatment if they DID find the baby wasn't growing enough??

Thanks for any help
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#2 of 8 Old 09-05-2009, 05:17 PM
 
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I have heard that there can be some serious complications associate with this. I think I would go with the u/s's to keep a watch.
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#3 of 8 Old 09-05-2009, 05:22 PM
 
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I would be very adament about monitoring the baby's growth in this situation.
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#4 of 8 Old 09-05-2009, 06:25 PM
 
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Coming from a less litigious culture, marginal insertions are acknowledged, mentioned and then decisions left in the hands of the parents in my area. Since the people I work with are homebirthing, almost everyone (if I recall correctly) has simply kept an eye on the bay's growth themselves, feeling perfectly capable of doing so without technology (which has negligible effects on said growth of a fetus), and then birthed the placenta physiologically. No pulling on a marginally inserted cord, that's for sure

ETA I have seen some incredible cord variations, some that are heart stopping, but have yet to see a truly compromised baby. OF COURSE this can happen, but I really wonder about the true rate....
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#5 of 8 Old 09-05-2009, 09:09 PM
 
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My last baby had a marginal cord insertion and I did not have any issues with IUGR or anything else. She was born 3 days past her due date and weighed 8 pounds 8 oz. Could you perhaps compromise and come in for extra fundal height measurements and if two in a row are small, then consent to a u/s? I might also ask how often there is a problem when we know about a marginal insertion. I had a 20 week anatomy scan and I guess mine wasn't recognized. If 95 % of those 5-7% are fine, I would be less likely to want a bunch of extra ultrasounds. Do some research and ask some questions to decide what you are most comfortable with.

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#6 of 8 Old 09-05-2009, 11:20 PM
 
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From personal experience I would go in for the extra monitoring. Get a second opinion and find out if it is just marginal or if it could be a velamentous insertion (where it inserts into and travels through the amnion before inserting into the placenta - those precious blood vessels don't have the protection of the wharton's jelly). Find out where exactly your placenta is attached in your uterus.

With my second son I was diagnosed with a marginal previa/low lying placenta. At 37 weeks I was finally cleared for a vaginal birth - they said my placenta had moved enough and I got the go ahead.

What we didn't know was that I had a velamentous insertion and vasa previa. About 30 minutes before I delivered my son I started passing a lot of blood. My midwife said it was normal bloody show. A few minutes after that my son's heart rate dropped. At some point his cord tore from the placenta and he lost most of his blood in just a matter of heartbeats. I delivered him as fast as I could and the NICU team did all they could but 12 hours after his birth his little body (all beautiful and perfect 9lbs 14oz) couldn't fight any longer and we removed him from life support.

If I had been correctly diagnosed I would have never had a vaginal delivery and my son would be alive today.

I don't write this to scare you. You've been given the gift of knowledge ahead of time that your umbilical cord might have issues and you have the opportunity to follow through. Most pregnancies go without a hitch but when something goes wrong it can be catastrophic.

I wish when I had searched on here for info about marginal previa and a low lying placenta someone would have mentioned umbilical cord problems that can go hand-in-hand with previa. I wish I would have known what to ask the doctor to look for when I had my ultrasounds.

I wish you peace in your decisions and a very healthy pregnancy!
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#7 of 8 Old 09-05-2009, 11:43 PM
 
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Cheshire, . I am so sorry for your experience. But thank you for sharing it with me. It is very important information to know and look for.

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#8 of 8 Old 09-06-2009, 12:43 AM
 
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If I were in your situation I would feel that given what I had learned about this particular pregnancy, the risk from 2 or 3 additional ultrasounds would be less than the risk of difficulties for the baby from growth restriction or some kind of cord accident. I would find the extra monitoring worthwhile on a risk/benefit basis as it could lead to different decisions about when and how to give birth that might change the outcome for the baby.

That said, I think the most important thing here is for YOU--and your partner, if you have one--to feel at peace with whatever decision you make.
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