An umbilical cord is a pretty big deal—after all, it’s that wondrous tube of tissue that connects your growing baby to your placenta.

So if you are diagnosed with veleramenta insertion or a similar condition, marginal cable insertion, it’s understandable that you feel distressed and have tons of questions, just like Community for bebeCenter Member Sarahali2f: “What was your experience with this condition? Did it affect your pregnancy or delivery? How was the medical follow-up, and was a C-Section required?”

Vellum cord insertion and marginal cord insertion mean that the umbilical cord is not attached to your placenta as it ideally should be, potentially risking pregnancy complications. But will these umbilical cord irregularities really affect your pregnancy and delivery? Here’s what you need to know.

What is a velament cable insert?

Typically, the umbilical cord connects the belly of the developing baby to the middle of the placenta. This is where the cable is most secure and can easily support the flow of vital nutrients and oxygen.

In vicarious cord insertion (VCI), however, the umbilical cord is inserted into the membranes that surround the placenta in the uterus. The blood vessels within the cord branch separately and directly into the bedding – meaning they are not fully protected by a gelatin-like substance called Thaton’s iron. That detached blood vessel is more likely to compress or break.

Marginal cord insertion sounds similar, but is a distinct condition: in this case, the umbilical cord is attached directly to the bedding, but only within about 2 centimeters of its edge, where there is very little tissue to support the connection.

What causes the insertion of a large vellum cable?

Experts don’t fully understand why VCI happens, but certain factors can increase your risk:

Marginal cord insertions occur in about 6% of pregnancies. Cord insertions tend to be rare, affecting about 1.5% of single pregnancies. With monochorionic twins, research suggests that the VCI rate is between 8% and 15%.

How is veletramental cord insertion diagnosed?

While vaginal bleeding, especially in the third trimester, can sometimes signal VCI, the condition usually causes no symptoms.

In fact, you may not be diagnosed with VCI until after Your pregnancy. While your ultrasound technician or healthcare provider might pick it up on an ultrasound (usually in the second trimester), it’s often missed.

“Usually we look at the placenta to find cord insertion,” says Layan Alrahmani, MD, Maternal-Fetal Board Certified Specialist and member of the BabyCenter Medical Advisory Board. “When we can’t find it in the placenta, we have to look at the whole uterus. That can be tricky because of the baby’s size and position in the second trimester.”

In many cases, VCI is discovered post-labour, after the placenta has been delivered and examined.

Does velamental cord insertion cause pregnancy complications?

While both umbilical cord insertion and marginal cord insertion have associated risks, they rarely cause serious problems during pregnancy or delivery.

“Serious complications are quite rare,” says Dr. Alrahmani.

That said, potential issues to be aware of include:

• Vasa Previa, which means the blood vessels that connect the umbilical cord and the placenta cover or lie near the opening of the cervix. Vasa Previa can lead to an emergency C-section if the vessels have ruptured during labor.
• The placenta may take longer to deliver and/or need to be manually removed after birth
• Compression or rupture of the umbilical vessels
• Increased risk of premature rupture of membranes (graduation)
• Increased risk of premature birth
• Having a baby that is small for their gestational age
• Having a baby who has a low Apgar score
• A baby who needs to stay in the Neonatal Intensive Care Unit (NICU)
• Stillbirth

In monochorionic tissue pregnancy, cord insertion is associated with differences in twin growth, as well as intrauterine growth restriction and two-separate transfusion syndrome (in which one twin receives too much blood and the other too little).

How is the vellum cable inserter usually treated?

There is no specific treatment for VCI. Instead, if you are diagnosed with VCI during pregnancy, your doctor or midwife will likely recommend taking certain precautions to help reduce the risk of possible complications.

Keep all your appointments, ask all your questions, make a plan and keep your mind open to everything that needs to be done to get your baby here safely.

– Community member for bebeCenter Ackosel

This could include monitoring the baby’s development with an ultrasound every four to six weeks and/or regular testing in anticipation. If your provider has concerns about blood vessels that might burst, they can discuss the possibility of inducing labor or scheduling a C-sound, whichever is best for you. During labor, your baby will receive continuous fetal monitoring to ensure a safer delivery.

For a member of the community for babycenter Ackosel, having a “VCI baby” raised a lot of concerns, but did not cause major questions during delivery.

“My biggest concern was possible problems during labor, but that ended up not being a problem because I had a c-section for labor,” she says. If you have a VCI, she advises, “Just keep all your appointments, ask all your questions, make a plan, and keep your mind open to whatever needs to happen to get you there safely to get your baby safe.”