During pregnancy, the umbilical cord serves as a mother and baby’s lifeline, supplying vital nutrients and oxygen. Its attachment to the placenta can differ, though, and the fetus’s growth and health may be impacted by these various attachment patterns.
Comprehending the distinct varieties of umbilical cord attachments is crucial for both prospective parents and medical professionals. Every kind of attachment has the potential to impact the fetus’s nutrition intake and the course of the birthing process.
The different kinds of umbilical cord attachments, their possible effects on fetal development, and the implications of these variations for the pregnancy and delivery will all be discussed in this article. By exploring this subject, we hope to offer lucid insights into the ways in which these factors contribute to the success of a pregnancy.
- Norm
- Abnormalities of attachment
- Causes
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Norm
A normal, healthy umbilical cord has three vessels: two arteries and one vein. The vein supplies the baby with maternal blood enriched with oxygen, vitamins, microelements, which are necessary for the growth and development of the fetus. Back to the arteries to the placenta, and from there – to the mother"s body, the products of the child"s metabolism (creatine, carbon dioxide, urea, etc.) are excreted. Normally, the umbilical cord is about 50-70 centimeters long. A longer umbilical cord creates the risk of entanglement and suffocation of the fetus during active movements. A shorter one limits the baby"s movements and also poses a danger during childbirth: its tension can provoke placental abruption, bleeding and acute hypoxia of the fetus. One side of the umbilical cord is adjacent to the anterior abdominal wall of the fetus, and the other to the placenta. Central attachment of the umbilical cord is considered normal. With this, the umbilical cord is attached to the central part of the "baby"s place".
The fetus’s health can be greatly impacted by the way the umbilical cord attaches to the placenta. Different forms of attachment, including velamentous, marginal, and central, can have an impact on nutrient delivery and blood flow, which may have an impact on fetal development and delivery outcomes. Recognizing these differences enables improved prenatal care and readys parents for any obstacles that may arise during pregnancy.
Abnormalities of attachment
- Marginal. With this attachment, the cord is joined to the placenta along its peripheral edge.
- Membranous. With this attachment, the umbilical cord is connected to the fetal membranes.
The vein and two arteries that guarantee the child’s life are attached too near to the edge of the "baby’s place" when there is marginal attachment. Pregnancy is usually unaffected by this kind of attachment, so it does not present a significant risk. When it comes to marginal attachment, doctors generally agree that a woman can give birth naturally. If there are no other indications, a cesarean section is not necessary.
The obstetric team’s mistakes during childbirth pose the only risk that the marginal (lateral) attachment of the umbilical cord can cause. Doctors occasionally assist with birthing by tugging on the umbilical cord. Such actions in the case of marginal attachment may cause the cord to tear, necessitating manual removal of the placenta.
In only 1–1.5 percent of cases does the cord attach itself to the umbilical cord in the womb by a membrane. The membranes that are separated from the placenta are next to the cord itself. The umbilical vessels approach the placental disk directly at this distance, completely unprotected by anything. Compared to marginal attachment, this placental anomaly is more dangerous.
When a child has the membrane type, they frequently experience developmental delay syndrome (caused by inadequate nutrition and oxygen during pregnancy). These infants frequently arrive underweight. Babies exposed to chronic hypoxia in the womb frequently experience delays in their mental and physical development, as well as central nervous system disorders.
About 9% of children whose umbilical cord membrane attachment is detected have developmental defects, such as cleft palate, congenital hip dislocation, absence of the esophagus, malformed heads, and so forth.
Although it’s not a common option, doctors say that membrane attachment can autonomously change into a normal, central one.
Such attachment is extremely risky during childbirth as well as during pregnancy. The umbilical cord is ripped when the integrity of the amniotic sac is damaged, causing bleeding and possibly the fetus’s death. In order to reduce the risks, doctors attempt to deliver the baby with such an abnormal umbilical cord via cesarean section.
Eccentric attachments is another term for these two primary categories of abnormalities in the umbilical cord. Paracentral attachment is the term used to describe a normal variant in which the cord is attached to the umbilical cord in the central region but is shifted slightly in any direction.
Causes
Anomalies in the umbilical cord’s development during the placenta-forming stage are the cause of the cord’s marginal attachment. This kind of anomaly typically affects expectant mothers who became pregnant at a relatively young age (between 18 and 23 years old) as well as women who are carrying their first child.
Pregnant women who must spend a lot of time standing up, especially if they frequently engage in strenuous physical activity, are at risk due to work or other obligations.
Pregnancy pathologies, such as polyhydramnios and oligohydramnios, placenta previa, and aberrant fetal positioning within the uterus, are not insignificant contributors to abnormal umbilical cord attachment. Marginal attachment most frequently coexists with other umbilical cord pathologies, such as nodes and aberrant vessel arrangement.
Although the exact causes of the umbilical cord’s membrane attachment are still unknown, observations indicate that women who carry twins or triplets or who give birth frequently tend to have this pathology.
Genetic pathologies of the fetus are taken into consideration among the causes of abnormal membrane (pleural) attachment. A child with Down syndrome frequently develops an umbilical cord membrane attachment.
| Type of Attachment | Effect on Fetus |
| Central Attachment | Umbilical cord attaches at the center of the placenta, providing balanced nutrient and oxygen supply to the fetus. |
| Marginal Attachment | Umbilical cord attaches at the edge of the placenta, which can sometimes lead to a less efficient nutrient and oxygen supply. |
| Velamentous Attachment | Umbilical cord attaches to the membranes rather than the placenta, increasing the risk of complications such as bleeding or cord rupture. |
| Succenturiate Lobe Attachment | Umbilical cord attaches to an additional lobe of the placenta, which can pose risks if the additional lobe detaches or if there is a problem with the blood flow. |
It is essential for expectant parents and healthcare professionals to comprehend the various kinds of umbilical cord attachments and how they affect the developing fetus. Different attachment styles may have different effects on the growth and delivery of the child. Although certain variants may result in complications, most cases end satisfactorily.
Understanding these attachment styles facilitates better pregnancy monitoring and management. Additionally, it equips parents with the knowledge they need to make the best decisions for their child’s health by preparing them for any possible scenario that may occur.
Overall, even though the fetus may be affected by the umbilical cord’s attachment, contemporary medical procedures are skilled at controlling and minimizing these effects. A healthy outcome for mother and child can be ensured by routine check-ups and open communication with medical professionals.
