Umbilical Cord Part 2

The umbilical cord normally inserts _____________ within the placenta.

Many conditions of umbilical cord insertion are not apparent before delivery.

______________ (marginal) placenta is when the cord inserts along the margin of the placenta and is usually of _______ clinical significance.

_________________ (membranous) cord insertion is when the cord inserts beyond the placental edge into the ___________ membranes of the placenta.

Prenatal identification of a _______________ insertion of the umbilical cord is a desirable clinical goal since these pregnancies have higher risks for adverse perinatal outcome.

Velamentous insertion may be complicated by ___________ of the umbilical vessels because they __________ (are or aren't) protected by Wharton's jelly

Velamentous insertion is associated with ____________ and _____________ _____________.

Risks of velamentous insertion- _______________ is vessels are torn. ____________ easily diagnosed on ultrasound.

A rare cord abnormality that is life threatening where the blood vessels of the umbilical cord cross the cervical os is known as _____________ ______________. This may be difficult to detect on routine obstetrical sonography but _______________ ______________ imaging can demonstrate it.

With vasa previa, the _____________ _____________ is the presenting part.

With vasa previa, it is usually _______________, but possibly ______________ bleeding in ____________ and _____________ trimester.

Complications of vasa previa include lack of ____________ to the fetus due to compression of cord during ____________.

Vasa previa Umbilical vessels may rupture during labor/delivery causing ____________ ______________.

Vasa Previa If undetected, the fetus will likely die at delivery from ruptured _____________ _____________ vessels or lack of ______________.

Vasa previa is associated with ______________ cord insertion

Vasa Previa A vaginal birth is required.

Name the cyst- Remnants of the allantois (a fluid filled structure that extends from the developing bladder in the base of the umbilical cord). These cysts tend to be closer to the fetal end of the cord, and most are small, typically 1-2 cm in diameter.

Name the cyst- Remnants of the vitteline duct. May be up to 6 cm in size, located close to the fetal end of the cord.

Difference between Allantoic and Omphalomesenteric duct cysts are only distinguishable by __________examination. They may be seen in association with anomalies of ___________________ and ___________________ tracts because they are developmentally related.

Name the umbilical cord mass- Benign tumor or the umbilical cord, may appear as echogenic mass located near the placental cord insertion. May cause vascular obstruction if becomes large in size.

Name the umbilical cord mass- Rare, rupture of wall of umbilical vein secondary to trauma or weakness that causes bleeding into jelly. Can be a lethal condition as it puts pressure on vein and results in umbilical vein thrombus.

Name the umbilical cord mass- Defined as a midline defect of the abdominal wall with extrusion of the abdominal contents into the base of the umbilical cord.

Omphalocele Occurs in approximately ____(#) per 10,000 births. There is a high incidence between omphalocele and ___________ anomalies (40-60%). There is also an association with ______________ defects.

With omphalocele, there will be elevated ____________ _____________ ______________ (_______________) and is seen sonographically as a mass in the ____________ of the umbilical cord.

Prognosis depends on ___________ of omphalocele and presence of other ______________. Treatment is _______________ after birth.