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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.
Anatomy scan image of a human placenta and umbilical cord (colour Doppler rendering) showing central placement of the cord in the placenta and three vessels in the cord, which is the normal physiology. A standard anatomy scan typically includes: [4] Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations
Risk factors for vasa praevia include velamentous insertion of the umbilical cord, placenta praevia in the second semester of the pregnancy, accessory placental lobes (succenturiate or bilobate placenta []), multiple gestation, and assisted reproduction, especially in vitro fertilisation; [2] an estimated 26% of instances are in pregnancies achieved with medical assistance. [3]
It usually develops between week 16 and 25 of pregnancy, during peak placental growth. The cause of the developmental effects on a surviving fetus may include necrotic embolisms from a dead fetus, low blood volume due to pooling in the dead fetus or velamentous cord insertion (insertion of the umbilical cord into the chorioamniotic membranes). [3]
Placental Disease can be diagnosed through technologies such as, Prenatal ultrasound evaluation and invasive foetal testing. The size of the foetus is taken into account through ultrasonography in terms of intrauterine growth restriction (IUGR). In conjunction with taking into account the maternal history. [8]
Occasionally, during pregnancy, there is a single umbilical artery (SUA) present in the umbilical cord, as opposed to the usual two. [1] This is sometimes also called a two-vessel umbilical cord, or two-vessel cord. Approximately, this affects between 1 in 100 and 1 in 500 pregnancies, making it the most common umbilical abnormality.
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Somatic errors are thus less likely than meiotic errors to be associated with either ultrasound abnormalities, growth problems or detectable levels of trisomy in small samples of prenatal CVS. Currently, there is no evidence that somatic errors, which lead to confined placental trisomy, are of any clinical consequence.