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The exact cause of velamentous cord insertion is unknown, although risk factors include nulliparity, [2] [6] the use of assisted reproductive technology, [6] [12] maternal obesity, [6] [7] and pregnancy with other placental anomalies. [9] Velamentous cord insertion is often diagnosed using an abdominal ultrasound.
There are three types of vasa praevia. In Type 1, there is a velamentous insertion with vessels crossing the cervix. In Type 2, the placenta is bilobed or has a succenturiate lobe, with unprotected vessels between the lobes. In Type 3, a portion of the placenta overlying the cervix has atrophied, leaving vessels at a margin exposed. [3]
Placenta problems (placenta praevia, placental abruption or placenta accreta) Failed labor induction Failed instrumental delivery (by forceps or ventouse (Sometimes, a trial of forceps/ventouse delivery is attempted, and if unsuccessful, the baby will need to be delivered by caesarean section.)
Normally the maternal circulation and the fetal circulation are kept from direct contact with each other, with gas and nutrient exchange taking place across a membrane in the placenta made of two layers, the syncytiotrophoblast and the cytotrophoblast. Fetal-maternal haemorrhage occurs when this membrane ceases to function as a barrier and ...
Upon examining the placenta after delivery, it was noted that the placenta demonstrated the appearance of a circumvallate placenta, and also showed evidence of abnormal umbilical cord insertion into the placenta. Postpartum, the mother had a good recovery and the newborn was discharged from the neonatal intensive care unit 105 days post-birth. [3]
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Twin anemia-polycythemia sequence (TAPS) is a chronic type of unbalanced fetal transfusion in monochorionic twins that results in polycythemia in the TAPS recipient and anemia in the TAPS donor due to tiny placental anastomoses. [1] Post-laser TAPS and spontaneous TAPS are the two forms of TAPS.
The B-Lynch suture or B-Lynch procedure is a form of compression suture used in obstetrics. It is used to mechanically compress an atonic uterus in the face of severe postpartum hemorrhage . It was developed by Christopher B-Lynch, a consultant obstetrician and gynaecological surgeon based at Milton Keynes General Hospital , Milton Keynes ...