The normal course and development of pregnancy cannot be imagined without two extremely important organs - the placenta and the umbilical cord. They are directly related to each other during the intrauterine development of the fetus. This article will tell you about the types of attachment of the umbilical cord to the placenta, as well as the rate and danger of abnormalities.
Norm
The umbilical cord or, as it may also be called, the umbilical cord is an elongated flagellum, inside which blood vessels pass. They are necessary for the fetus to receive all the necessary nutrients for growth and development during its intrauterine life. The normal umbilical cord looks like a gray-blue cord that attaches to the placenta. Normally, it is formed at the earliest stage of pregnancy and continues to develop along with the growing baby.
The umbilical cord can be easily visualized already in the 2nd trimester of pregnancy. It is well defined during an ultrasound examination. Also, by means of an ultrasound scan, the doctor can also assess the state of the actively forming placental tissue. During the examination, the doctor necessarily evaluates how the umbilical cord attaches to the placenta.
Finally, the umbilical cord is formed only by 2 months from the moment of conception. As the umbilical cord grows, its length also increases. At first, the umbilical cord is only a few centimeters long. It gradually increases and reaches, on average, 40-60 cm. The length of the umbilical cord can be finally determined only after childbirth. While the baby is in the womb, the umbilical cord may curl up somewhat.
Normally, the umbilical cord is attached to the center of the placenta. Doctors call this arrangement central. In this case, intrauterine development proceeds physiologically. The blood vessels in the umbilical cord reach the placenta and provide sufficient blood flow.
With eccentric attachment of the umbilical cord, it is attached not to the central part of the placental tissue, but closer to its edge. Usually in this case, the umbilical cord does not reach a couple of centimeters to the edge of the placenta. Eccentric attachment of the umbilical cord is usually not accompanied by the development of any adverse functional disorders. However, paracentral attachment of the umbilical cord to the placental tissue requires a rather attentive attitude of doctors to the development of pregnancy.
The easiest way to determine the type of attachment of the umbilical cord to the placenta is if the placental tissue is located along the anterior or lateral wall of the uterus.
If, for some reason, the placenta is located on the back wall, then it becomes much more difficult to determine the type of attachment. In this case, it is better to conduct examinations on expert-level devices. This allows for more informative and accurate results.
However, the central attachment of the umbilical cord to the placental tissue is not always formed during pregnancy. Abnormal attachment options in this case can lead to the development of various functional disorders.
Pathology
Doctors identify several abnormal attachments of the umbilical cord to the placenta. So, the umbilical cord can be directly attached to the edge of the placenta. Experts call this attachment edge. This condition is characterized by the fact that the blood vessels in the umbilical cord are close enough to the edge of the placenta.
Lateral attachment of the umbilical cord to the placenta is not always the cause leading to the development of dangerous complications during pregnancy. Obstetricians-gynecologists especially highlight the condition in which the umbilical cord is located at a distance of less than 0.5 radius of the placenta from the edge. In this case, the risk of developing various complications is quite high.
Another clinical option for attaching the umbilical cord to the placenta is the meningeal. This condition is also called puffy. In this case, the blood vessels that are in the umbilical cord attach to the amniochorionic membrane.
Normally, the arterial vessels that are in the umbilical cord are covered with warton jelly. This gelatinous substance protects the arteries and veins in the umbilical cord from various damage. When the umbilical cord is attached to the placenta, the blood vessels are not covered with warton jelly along their entire length. This contributes to the fact that the risk of developing various traumatic injuries of the arteries and veins is quite high.
According to statistics, the sheathing of the umbilical cord is found during pregnancy with one baby in about 1.2% of cases. If the expectant mother is expecting twins, then in such a situation the risk of developing this pathology increases and is already almost 8.8%.
In obstetric practice, there are cases when the umbilical cord can change its attachment to the placenta. The reasons for this can be different. This may be due to inaccuracies in determining the initial place of attachment of the umbilical cord to the placenta (the notorious human factor), as well as due to migration of placental tissue during pregnancy. Note that the change in the place of attachment of the umbilical cord still occurs infrequently.
Possible consequences
Abnormal attachment of the umbilical cord to the placenta threatens the development of a number of complications that can occur at different stages of pregnancy. In order to determine them in a timely manner, doctors resort to various diagnostic methods, the main of which is ultrasound examination. In this case, an ultrasound scan is prescribed several times. This is necessary so that doctors can assess the dynamics of the development of pathology and correct the arising disorders in time.
Since blood vessels pass through the umbilical cord, to assess the intensity of blood flow, doctors resort to the appointment of another diagnostic method - Doppler sonography. This examination allows you to assess whether there are any defects in the blood supply to the placenta and the fetus. Possible complications largely depend on how the umbilical cord is attached to the placenta.
With the membrane attachment of the umbilical cord to the placenta, the risk of developing various traumatic injuries is quite high. Also, with this type of attachment, the risk of developing dangerous bleeding is quite high, which can develop during childbirth. Some researchers believe that with this type of attachment of the umbilical cord to the placenta, the risk of developing intrauterine growth retardation is quite high.
In some cases, the membranous attachment of the umbilical cord to the placenta is accompanied by the development of combined pathologies. So, in this condition, anomalies and malformations of the internal organs of the fetus (including heart and vascular defects, defects in the structure of the musculoskeletal system, esophageal atresia), vascular pathologies, the appearance of additional lobules in the placental tissue and other disorders can also develop.
Another possible complication that can develop with the meningeal attachment of the umbilical cord to the placenta is the development of intrauterine fetal hypoxia. In this case, the child's body does not receive a sufficient amount of oxygen, which is necessary for "tissue" breathing. The resulting oxygen deficiency contributes to the fact that the functioning of the internal organs of the fetus is impaired. This situation is fraught with the development of dangerous pathologies that may appear even after the birth of a child.
With the membranous attachment of the umbilical cord to the placenta, a cesarean section is often a method of obstetrics. In some cases, natural childbirth can be dangerous by the development of dangerous birth injuries and injuries. In order to avoid them, doctors prescribe a cesarean section.
It should be noted that the choice of the method of obstetrics is selected individually, taking into account the various characteristics of the course of a particular pregnancy.
For low placentation during pregnancy and the location of the placenta, see the following video.
