Umbilical cord in wrong place ?

[mecia]

I had my 20 week anatomy scan today, and the doctor said my umbilical cord is not in the center? She said that it should be centered, and mine isn't. It can cause low birth weight. Anyone else have this..? I go back in 6 weeks for them to check growth. She said it isn't life threatening, but can cause development growth delays. Little bit nervous now.

 

[FeistyMom]

I had not heard of umbilical placement problems before, but I know it is nerve-wracking any time we hear there 'may' be something 'wrong'. Hopefully it turns out it was just an oddity of the scan, and not really a problem at all!

Hang in there!

 

[MOMRETTIRC]

I had marginal cord insertion that was found at my 20 week ultrasound. They told me it could cause growth restriction in the third trimester. It was offered to do growth scans to see if his growth was okay but because I was measuring correctly I never got them. My son was born at 42 weeks one day And weighed 9 1/2 pounds. So I guess it didn't affect him and all was well. My midwife told me that marginal cord insertion is another form of normal. It's Something to be aware of but I wouldn't worry about it too much. Congrats on your pregnancy and enjoy the rest of it!

 

[mecia]

I had marginal cord insertion that was found at my 20 week ultrasound. They told me it could cause growth restriction in the third trimester. It was offered to do growth scans to see if his growth was okay but because I was measuring correctly I never got them. My son was born at 42 weeks one day And weighed 9 1/2 pounds. So I guess it didn't affect him and all was well. My midwife told me that marginal cord insertion is another form of normal. It's Something to be aware of but I wouldn't worry about it too much. Congrats on your pregnancy and enjoy the rest of it!

Thank you for the reply! Your baby was far from being small. The doctor keeps telling me be pre pared for a tiny baby. I'm glad to see it's not as serious as they are making it seem.

 

[beagleowner]

I had the same experience with a marginal cord insertion and a 9lb 7oz baby girl. Because of the cord condition I ate a ton of protein and we did monthly growth ultrasounds where she measured between 50th and 55th percentile in size....supposedly. What a joke! She was huge.

Actually in my experience, they initially diagnosed a velamentous cord insertion at the 20-week ultrasound which is more significant than a marginal one, but then upon further ultrasounds were unsure about which it was. The difference is that marginal is a normal umbilical cord but placed off-center (usually umbilical cords are centered). Velamentous, on the other hand, is off-center and travels through the amniotic sac unprotected by jelly for a length before inserting into the placenta.

My doctors were not concerned one bit. They didn't even tell me about it until my next scheduled appointment and then shrugged it off. I on the other hand FREAKED out when it was first told to me and was devastated for weeks and demanded a consultation with a perinatologist but ultimately after talking to experts realized...

If the cord insertion is high and away from the cervical os/birth canal, neither velamentous nor marginal insertions pose much concern until birth, at which point if your cord is velamentous (yours doesn't seem to be but for others in this situation) you have an increased risk of needing a c-section, but that is it (I didn't need one and had a totally easy birth despite her size).

The real danger comes when your cord insertion is over the birth canal. If this is the case and it is not found before birth, the baby could die during birth by severing the cord and bleeding out. If it is the case and it IS diagnosed prenatally, then they just do a c-section and everything is fine.

The perinatologist I saw told me that he saw velamentous cord insertion roughly once per week and it was something that required more follow up roughly twice a year. He provided me with research which noted that this condition was typically discovered after birth only as an incidental finding (they are only now diagnosing before birth due to improved color-doppler ultrasound technology which shows blood flow), and it is associated with negative outcomes probably only because when a negative outcome occurs they go looking for reasons why and that's when the cord insertion is reported. Whereas the vast majority of the time it causes no problems so it is not reported. Marginal cord insertion is not much of a big deal at all. There is some concern that it does sometimes cause growth restriction by not allowing all of the nutrients to go to the baby because of its off-center placement, but some people don't believe that this is the case. My OB office said that they have never seen restricted growth with it, although there are reports that it can happen....so you may consider asking if monthly growth ultrasounds are indicated.

So in other words, put the worry out of your mind as much as you can! Don't let it ruin your pregnancy. I let it totally get to me and it turned out all the doctors I saw were right and it was a non-issue completely. Ask your doctor to print out the "Up To Date" research on it (and ask them to explain what it is). That will put your mind at ease.

Seriously it will be fine. But I know how you feel!

 

[amjon]

VCI absolutely can be deadly to the baby. A CS us a MUST. One of my friends lost her first because they didn't know about it and nearly lost her second and they did know. If the doctor tries to downplay it find another.

 

[mecia]

I had the same experience with a marginal cord insertion and a 9lb 7oz baby girl. Because of the cord condition I ate a ton of protein and we did monthly growth ultrasounds where she measured between 50th and 55th percentile in size....supposedly. What a joke! She was huge.

Actually in my experience, they initially diagnosed a velamentous cord insertion at the 20-week ultrasound which is more significant than a marginal one, but then upon further ultrasounds were unsure about which it was. The difference is that marginal is a normal umbilical cord but placed off-center (usually umbilical cords are centered). Velamentous, on the other hand, is off-center and travels through the amniotic sac unprotected by jelly for a length before inserting into the placenta.

My doctors were not concerned one bit. They didn't even tell me about it until my next scheduled appointment and then shrugged it off. I on the other hand FREAKED out when it was first told to me and was devastated for weeks and demanded a consultation with a perinatologist but ultimately after talking to experts realized...

If the cord insertion is high and away from the cervical os/birth canal, neither velamentous nor marginal insertions pose much concern until birth, at which point if your cord is velamentous (yours doesn't seem to be but for others in this situation) you have an increased risk of needing a c-section, but that is it (I didn't need one and had a totally easy birth despite her size).

The real danger comes when your cord insertion is over the birth canal. If this is the case and it is not found before birth, the baby could die during birth by severing the cord and bleeding out. If it is the case and it IS diagnosed prenatally, then they just do a c-section and everything is fine.

The perinatologist I saw told me that he saw velamentous cord insertion roughly once per week and it was something that required more follow up roughly twice a year. He provided me with research which noted that this condition was typically discovered after birth only as an incidental finding (they are only now diagnosing before birth due to improved color-doppler ultrasound technology which shows blood flow), and it is associated with negative outcomes probably only because when a negative outcome occurs they go looking for reasons why and that's when the cord insertion is reported. Whereas the vast majority of the time it causes no problems so it is not reported. Marginal cord insertion is not much of a big deal at all. There is some concern that it does sometimes cause growth restriction by not allowing all of the nutrients to go to the baby because of its off-center placement, but some people don't believe that this is the case. My OB office said that they have never seen restricted growth with it, although there are reports that it can happen....so you may consider asking if monthly growth ultrasounds are indicated.

So in other words, put the worry out of your mind as much as you can! Don't let it ruin your pregnancy. I let it totally get to me and it turned out all the doctors I saw were right and it was a non-issue completely. Ask your doctor to print out the "Up To Date" research on it (and ask them to explain what it is). That will put your mind at ease.

Seriously it will be fine. But I know how you feel!

Thank you very much for your input! I am going in a few weeks for a growth scan and to double check the cord. I feel relief knowing it isn't such a huge deal and things can be just fine

 

[beagleowner]

VCI absolutely can be deadly to the baby. A CS us a MUST. One of my friends lost her first because they didn't know about it and nearly lost her second and they did know. If the doctor tries to downplay it find another.

Just to put this out there....I talked to two midwives, two OBs and two perinatologists when they thought I had velamentous cord insertion (ended up being marginal) and none of them thought a CS was a "must" as my cord insertion was way high. They said that in my case they would closely monitor the baby during birth and if needed (if she wasn't tolerating the contractions) could do a CS in moments. I was told by many on the internet to push for a section anyway, but the truth is prenatal diagnosis of this condition is in its infancy (no pun intended) and there is no standard of care for it. Some doctors will check someone with VCI into the hospital at 32 weeks preventatively, some will put no restrictions on you whatsoever.

If a patient has vasa previa in addition to velamentous cord insertion, in that case you are correct and a c-section is an absolute must. That situation is pretty dangerous and almost always fatal when not prenatally diagnosed. When prenatally diagnosed and given correct care, even vasa previa (the worst-case scenario for someone with velamentous cord insertion) has a survival rate basically the same as someone without any cord complications. But yes, a section is a must in that case.

So, so sorry to hear about your friend.

 

[amjon]

VCI absolutely can be deadly to the baby. A CS us a MUST. One of my friends lost her first because they didn't know about it and nearly lost her second and they did know. If the doctor tries to downplay it find another.

Just to put this out there....I talked to two midwives, two OBs and two perinatologists when they thought I had velamentous cord insertion (ended up being marginal) and none of them thought a CS was a "must" as my cord insertion was way high. They said that in my case they would closely monitor the baby during birth and if needed (if she wasn't tolerating the contractions) could do a CS in moments. I was told by many on the internet to push for a section anyway, but the truth is prenatal diagnosis of this condition is in its infancy (no pun intended) and there is no standard of care for it. Some doctors will check someone with VCI into the hospital at 32 weeks preventatively, some will put no restrictions on you whatsoever.

If a patient has vasa previa in addition to velamentous cord insertion, in that case you are correct and a c-section is an absolute must. That situation is pretty dangerous and almost always fatal when not prenatally diagnosed. When prenatally diagnosed and given correct care, even vasa previa (the worst-case scenario for someone with velamentous cord insertion) has a survival rate basically the same as someone without any cord complications. But yes, a section is a must in that case.

So, so sorry to hear about your friend.

My friend was "monitored" and her baby DID end up dying. They couldn't get him out fast enough at that point as things went downhill fast. No way would I risk anything but a planned CS.

 

[beagleowner]

VCI absolutely can be deadly to the baby. A CS us a MUST. One of my friends lost her first because they didn't know about it and nearly lost her second and they did know. If the doctor tries to downplay it find another.

Just to put this out there....I talked to two midwives, two OBs and two perinatologists when they thought I had velamentous cord insertion (ended up being marginal) and none of them thought a CS was a "must" as my cord insertion was way high. They said that in my case they would closely monitor the baby during birth and if needed (if she wasn't tolerating the contractions) could do a CS in moments. I was told by many on the internet to push for a section anyway, but the truth is prenatal diagnosis of this condition is in its infancy (no pun intended) and there is no standard of care for it. Some doctors will check someone with VCI into the hospital at 32 weeks preventatively, some will put no restrictions on you whatsoever.

If a patient has vasa previa in addition to velamentous cord insertion, in that case you are correct and a c-section is an absolute must. That situation is pretty dangerous and almost always fatal when not prenatally diagnosed. When prenatally diagnosed and given correct care, even vasa previa (the worst-case scenario for someone with velamentous cord insertion) has a survival rate basically the same as someone without any cord complications. But yes, a section is a must in that case.

So, so sorry to hear about your friend.

My friend was "monitored" and her baby DID end up dying. They couldn't get him out fast enough at that point as things went downhill fast. No way would I risk anything but a planned CS.

How terrible. I can understand. But truthfully that can happen in any birth, and you weigh it against the risks that c-sections carry in and of themselves.

 

[amjon]

VCI absolutely can be deadly to the baby. A CS us a MUST. One of my friends lost her first because they didn't know about it and nearly lost her second and they did know. If the doctor tries to downplay it find another.

Just to put this out there....I talked to two midwives, two OBs and two perinatologists when they thought I had velamentous cord insertion (ended up being marginal) and none of them thought a CS was a "must" as my cord insertion was way high. They said that in my case they would closely monitor the baby during birth and if needed (if she wasn't tolerating the contractions) could do a CS in moments. I was told by many on the internet to push for a section anyway, but the truth is prenatal diagnosis of this condition is in its infancy (no pun intended) and there is no standard of care for it. Some doctors will check someone with VCI into the hospital at 32 weeks preventatively, some will put no restrictions on you whatsoever.

If a patient has vasa previa in addition to velamentous cord insertion, in that case you are correct and a c-section is an absolute must. That situation is pretty dangerous and almost always fatal when not prenatally diagnosed. When prenatally diagnosed and given correct care, even vasa previa (the worst-case scenario for someone with velamentous cord insertion) has a survival rate basically the same as someone without any cord complications. But yes, a section is a must in that case.

So, so sorry to hear about your friend.

My friend was "monitored" and her baby DID end up dying. They couldn't get him out fast enough at that point as things went downhill fast. No way would I risk anything but a planned CS.

How terrible. I can understand. But truthfully that can happen in any birth, and you weigh it against the risks that c-sections carry in and of themselves.

Yes sadly that's true. Adding an addition risk in I wouldn't take any chances though. My boys were breech and CS was recommended. I REALLY did not want one but knowing they were safe was more important to me than trying for vaginal.

 

[beagleowner]

VCI absolutely can be deadly to the baby. A CS us a MUST. One of my friends lost her first because they didn't know about it and nearly lost her second and they did know. If the doctor tries to downplay it find another.

Just to put this out there....I talked to two midwives, two OBs and two perinatologists when they thought I had velamentous cord insertion (ended up being marginal) and none of them thought a CS was a "must" as my cord insertion was way high. They said that in my case they would closely monitor the baby during birth and if needed (if she wasn't tolerating the contractions) could do a CS in moments. I was told by many on the internet to push for a section anyway, but the truth is prenatal diagnosis of this condition is in its infancy (no pun intended) and there is no standard of care for it. Some doctors will check someone with VCI into the hospital at 32 weeks preventatively, some will put no restrictions on you whatsoever.

If a patient has vasa previa in addition to velamentous cord insertion, in that case you are correct and a c-section is an absolute must. That situation is pretty dangerous and almost always fatal when not prenatally diagnosed. When prenatally diagnosed and given correct care, even vasa previa (the worst-case scenario for someone with velamentous cord insertion) has a survival rate basically the same as someone without any cord complications. But yes, a section is a must in that case.

So, so sorry to hear about your friend.

My friend was "monitored" and her baby DID end up dying. They couldn't get him out fast enough at that point as things went downhill fast. No way would I risk anything but a planned CS.

How terrible. I can understand. But truthfully that can happen in any birth, and you weigh it against the risks that c-sections carry in and of themselves.

Yes sadly that's true. Adding an addition risk in I wouldn't take any chances though. My boys were breech and CS was recommended. I REALLY did not want one but knowing they were safe was more important to me than trying for vaginal.

I hear you. It's a complicated condition that until recently was only found after birth, which is why I insisted on a referral to a perinatologist even though my OB said it was unnecessary. I didnt want to take chances. And I got a free 3D ultrasound out of it, so hey!

 

[Beneli]

My first son had a marginal insertion (found at birth). He was born 39w3d at 6lbs12 oz. Always ahead of milestones and now a healthy and intelligent 5 year old