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Case Reports
. 2018 Nov;97(45):e13221.
doi: 10.1097/MD.0000000000013221.

Vaginal delivery in a pregnant woman with cord prolapse, velamentous cord insertion, and fetal vertex presentation: A case report

Pei-Chen Li  1 , Dah-Ching Ding  1   2
Affiliations
Case Reports

Vaginal delivery in a pregnant woman with cord prolapse, velamentous cord insertion, and fetal vertex presentation: A case report

Pei-Chen Li et al. Medicine (Baltimore). 2018 Nov.

Abstract

Rationale: We report a rare case of a pregnant woman with cord prolapse, velamentous cord insertion (VCI), and fetal vertex presentation who completed vaginal delivery.

Patient concerns: Without having undergone regular antepartum examinations, a 31-year-old pregnant woman, gravida 6, para 4, abortion 1, presented at 37 weeks and 3 days of gestation. She had regular labor pain and bloody show.

Diagnoses: Cord prolapse during labor and VCI after delivery.

Interventions: Per vaginal examination at 11:20 PM revealed a fully dilated cervix. Thirty minutes later, artificial rupture of the membrane was performed, and an overt prolapsed cord approximately 10-cm long was palpated in the vagina. Fetal heartbeat decelerated to 60 bpm. After fundal pushing for some minutes, a female baby weighing 2130 g was delivered at 11:54 PM with a pediatrician on standby. Apgar scores were 7 (0 minute), 9 (5 minutes), and 10 (10 minutes). The placenta weighed 870 g and was delivered 5 minutes later, and VCI was discovered.

Outcomes: Her postpartum course was uncomplicated and both the patient and infant were discharged 3 days later.

Lessons: A pregnant woman with umbilical prolapse, VCI, and a fetal vertex presentation can successfully deliver a baby through the vagina. Factors contributing to the success of the reported vaginal delivery might have been a small fetus, multipara status, and immediate management.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The fetal heart tracing and gross picture of the placenta. (A) Fetal monitor indicated the late deceleration of heart tracing. (B) The placenta exhibited velamentous cord insertion.
See this image and copyright information in PMC

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