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Velamentous cord insertion is a complication of pregnancy where the umbilical cord is inserted in the fetal membranes. It is a major cause of antepartum hemorrhage that leads to loss of fetal blood and associated with high perinatal mortality.
In Type 1, there is a velamentous insertion with vessels running over the cervix. In Type 2, unprotected vessels run between lobes of a bilobed or succenturiate lobed placenta. In Type 3, a portion of the placenta overlying the cervix undergoes atrophy. In this type, there is a normal placental cord insertion and the placenta has only one lobe.
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]
Fetal-maternal haemorrhage is the loss of fetal blood cells into the maternal circulation. It takes place in normal pregnancies as well as when there are obstetric or trauma related complications to pregnancy.
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 pathology (velamentous insertion, succenturiate lobes, bipartite i.e. bilobed placenta etc.) [13] Baby is in an unusual position: breech (buttocks first) or transverse (lying horizontally across the womb). Placenta previa is itself a risk factor of placenta accreta. Alcohol use during pregnancy was previously listed as a risk factor ...
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This test is run from cord blood. [2] In some cases, the direct coombs will be negative but severe, even fatal HDN can occur. [35] An indirect coombs needs to be run in cases of anti-C, [36] anti-c, [36] and anti-M. Anti-M also recommends antigen testing to rule out the presence of HDN. [26] Hgb - the infant's hemoglobin should be tested from ...