Birth Injuries from Problems with Velamentous Cord Insertion

Friday, June 9, 2023

Birth Injuries from Problems with Velamentous Cord Insertion

Written by Malman Law, reviewed by Steve J. Malman.

Welcoming the birth of your child should be an experience you can cherish. Sadly, many pregnancies involve cord insertion complications. While some cord insertions will correct themselves over time, others can affect the baby’s development and even prove fatal.

If your pregnancy involved a velamentous cord insertion, our birth injury attorneys at Malman Law are here to help. Below we discuss everything you need to know about velamentous cord insertion and when you may be entitled to compensation.

The Umbilical Cord and Placenta

In a normal pregnancy, the umbilical cord is attached to the infant’s belly button and inserted into the center of the placenta. The umbilical cord consists of one vein and two arteries. The vein carries nourishment (oxygen and food) from the placenta to your baby, while the arteries carry waste from the baby back to the placenta.

Both the umbilical cord and placenta are temporary organs that develop in a woman’s uterus during pregnancy. The placenta usually attaches to the wall of the uterus, either forming on the top, side, front, or back.

When your baby is born, an obstetrician will take care of cutting the umbilical cord. You can expect to deliver the placenta anytime between 30-60 minutes following your delivery.

What is a Velamentous Cord Insertion?

When the umbilical cord does not attach properly to the placenta, this is known as a marginal cord insertion. In marginal insertions, the umbilical cord is within two centimeters from the edge of the placenta.

Although rare, a marginal cord insertion can turn into a velamentous cord insertion during the third trimester, sometimes even sooner. A woman is considered to be in her third trimester between 29 to 40 weeks gestation. In a velamentous cord insertion, the umbilical cord attaches to the membranes outside of the placenta, not the placenta itself.

Velamentous cord insertions are rare, occurring in only 1% of single-birth pregnancies and 6% of multiple-birth pregnancies. However, the rate increases to 15% for pregnancies in which twins share the same placenta (identical twins).

Risk Factors for Developing the Condition

While the medical field cannot identify the cause of a velamentous cord insertion, there are certain factors that increase the likelihood of developing this condition. These factors include:

• Pregnancies involving multiple births
• Pregnancies that involve in vitro fertilization (IVF)
• Pregnancies involving a first-birth parent
• Pregnancies where the placenta attaches to the lower portion of the uterus, near your cervix (placenta previa)
• Pregnancies where unprotected blood vessels from the umbilical cord travel across the opening of your cervix (vasa previa)

If you fit into any of these pregnancy categories, it is important that you discuss the risk of a velamentous cord insertion with your healthcare provider.

What Are the Dangers of Velamentous Cord Insertion?

A velamentous cord insertion has the potential to affect both your health and your baby’s development. In a normal pregnancy, the umbilical cord is usually composed of a gelatinous connective tissue, known as Wharton’s Jelly, that protects its vein and two arteries.

In velamentous cord insertion cases, Wharton’s Jelly is not present to protect the umbilical cord. Due to this, the blood vessels in the umbilical cord are at a higher risk of bleeding.

A velamentous cord insertion increases the risk of:

• Premature birth: you may have to deliver prior to your due date
• Placenta abruption: the placenta may separate from the wall of the uterus
• Preeclampsia: a condition that usually presents 20 weeks and later into pregnancy; symptoms include increased blood pressure, kidney damage, vomiting, severe headaches, and seizures (in more severe cases)
• Underweight newborn: your baby may be smaller than other newborns, and may require special care in the neonatal ICU unit.
• Low Apgar scores: your doctor will assess your baby’s overall health, examining the infant’s breathing, heart rate, muscle tone, reflexes, and skin color. Your physician will assign a score from 0-10. Any score below 7 indicates that your baby will need further medical attention.

Your healthcare provider may suggest that you schedule a cesarean section (C-section) to reduce birth complications.

Diagnosing a velamentous cord insertion is crucial for both the survival of the mother and her child. The failure of an obstetrician or health care provider to diagnose this condition can result in dire consequences.

Symptoms and Diagnosing Velamentous Cord Insertion

A velamentous cord insertion may present with vaginal bleeding during the pregnancy, especially in a mother’s third trimester. The fetus may have a slow heart rate due to a reduced blood supply.

Velamentous cord insertion can be diagnosed through an abdominal ultrasound, normally during the second trimester. Ultrasound will depict the placental cord insertion site.

This visualization is usually taken by a doppler ultrasound. In a doppler ultrasound, sound waves are used to create the image of blood moving through blood vessels. A doppler ultrasound can also detect a fetal heart rate, but not until 10-12 weeks gestation.

Once diagnosed, a transvaginal ultrasound using color doppler may be used to determine the risk level of any rupture of the umbilical cord vessels.

Physician Misdiagnosis and Mistreatment

Although easily detectable, some physicians may fail to meet the standard of care required in diagnosing and treating this abnormal cord insertion.

A velamentous cord insertion may be misdiagnosed if:

• A physician fails to recognize the signs and symptoms
• A physician fails to accurately see the insertion point of the umbilical cord through ultrasound
• A physician fails to use the appropriate technology

If a pregnancy involves a velamentous cord insertion, the healthcare provider should take the following precautionary steps:

• Monitor fetal growth every four to six weeks
• Perform regular non-stress tests on the fetus (monitors the baby’s heart rate and movement)
• Schedule a C-section around 34 weeks to reduce the chance of blood vessels bleeding
• If delivering vaginally, induce labor at 40 weeks
• Vigilant monitoring of baby’s vitals during delivery

If you are experiencing a velamentous cord insertion in your pregnancy, your physician must monitor your condition routinely.

If your physician fails to take the proper precautions in treating the condition, he or she can be held liable for medical malpractice. Our birth injury attorneys have handled numerous medical malpractice cases, recovering impressive settlements for our clients.

A Chicago Birth Injury Lawyer Protecting You

If your newborn has suffered injuries from a velamentous cord insertion, you may not know who to turn to. If you have been a victim of medical malpractice, you may be entitled to compensation.

We understand that no amount can undo the suffering that both you and your child have endured. Nonetheless, if your child has been injured due to a doctor’s negligence, you should not be responsible for any resulting medical bills. Contact us today to schedule your free consultation.