Velamentous cord insertion (VCI) is a rare but significant obstetric condition where the umbilical blood vessels insert into the membranes instead of directly into the placenta. This abnormal insertion leaves the vessels exposed and more prone to spontaneous rupture, which can lead to fetal hemorrhage or other complications during labor. Early diagnosis of VCI is essential to prevent severe maternal and fetal outcomes. In this case report, we describe a 27-year-old pregnant woman who attended a routine third-trimester antenatal check-up. During the ultrasound examination, grade I polyhydramnios was noted, along with suggestive signs of a trivascular umbilical cord with a velamentous insertion 35 mm from the nearest placental margin.
The early diagnosis of VCI, confirmed through the prenatal ultrasound, was crucial in guiding the management of the pregnancy. Given the risks associated with VCI, an elective cesarean section was planned for delivery at term, which allowed for a safe delivery and avoided potential complications such as umbilical cord rupture or fetal distress during labor. This case highlights the importance of early detection of VCI, ideally from the second trimester, using imaging techniques such as transabdominal ultrasound and color Doppler. These tools can provide clear visualization of abnormal cord insertions, enabling healthcare providers to anticipate complications and tailor the delivery plan accordingly.
Timely identification of velamentous cord insertion not only helps in minimizing risks but also significantly improves the outcomes for both mother and baby. With proper prenatal monitoring and careful delivery planning, the risks associated with VCI can be greatly reduced, emphasizing the importance of routine ultrasound examinations during pregnancy.
