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velementous cord insertion-twin B

Last post 07-21-2010 11:42 AM by midwifea. 2 replies.
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  • 07-20-2010 5:21 PM

    velementous cord insertion-twin B

     I appologize to those who might see this more than once. We are trying to gather opinions/experiences from as many places as we can.

    I have a client planning a homebirth with twins. First baby was born at home as well as her twin siblings when she was a teenager. They are very committed to a homebirth.

    The ultrasound showed that twin B has a velementous cord insertion. She is growing well, a bit bigger than her brother(estimate, of course). The Dr that they consulted with for the ultrasound is reccomending she not labor at home due to fear of her cord tearing after baby A is born and having only moments to birth B. Now, this Dr does alot of ultrasounds for all/most of the midwives in town and is not an alarmest. This is actually the first time I have heard of him suggesting the client not have a homebirth. (Im sure there have been others, Im just saying) That is one reason why we are taking this very seriously and trying to determine what the risks are and if a homebirth would really be contradicted in this case.

    I would appreciate any insight. Thanks!

  • 07-21-2010 4:54 AM In reply to

    Re: velementous cord insertion-twin B

    Are babies sharing membranes?  Surely not, and surely therefore his birth would not be more dangerous than a singleton with a velamentous insertion?  (i'm genuinely asking, i'm not a midwife!).  Where are the vessels running?  Is it slightly velamentous or severely so?  Will his membranes rupturing be likely to tear vessels?  By what process exactly does the doctor fear the cord will be torn?

    In my uneducated opinion the cord insertion probably isn't more relevant than it would be for a singleton, and most singletons with this issue don't show up until after birth because they don't routinely scan singleton pregnancies for that sort of thing.

    I had a baby with a marginal, velamentous insertion (i think that's how one would put it - placenta was heart-shaped, cord inserted at one edge with vessels going along the membranes for 1-2cm before inserting) and a true knot 6 weeks ago and all was fine because my midwife just sat there while we got on with it.  No-one ruptured anything, or pulled anything.  Obviously that is more or less useless anecdotal rambling!

    Me 32, DH 41, DD 2006, DD 2010, DS 2013
  • 07-21-2010 11:42 AM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: velementous cord insertion-twin B

    I too have seen, many times, a velamentous insertion with singleton babes.  Velamentous with marginal placement cords, are anomalies that found after birthing cause homebirth midwives to comment, 'wow if that had been seen on ultrasound you would've had a CS' and not much more.

    How many weeks is mama?

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
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