In July, I reported on an umbilical cord anomaly known as, Velamentous Cord Insertion.  Umbilical cord variations can include false knots, true knots and nuchal cord (the technical term for the cord being wrapped or kinked up into the area near the neck and head or other presenting part). According to Military Obstetrics & Gynecology, "Nearly half of babies have the umbilical cord wrapped around something (neck, shoulder, arm, etc.), and this generally poses no particular problem for them." 

Velamentous Insertion on the other hand only occurs in 1% of births and can be accompanied by Vasa Previa, in which the unprotected vessels of the cord run through the amniotic sac in front of the baby's presenting part. Vasa Previa occurs in one per 2000-3000 deliveries. If the vessels are compressed during labor, the baby's heart rate can become dangerously slow or the vessels can be blocked by a clot.  The baby can bleed to death if vessels are torn when the bag of waters breaks.  Ruptured vasa previa results in a 50-75% fetal death rate(Beall & Ross, 2007).  

At Thanksgiving, we attended the home birth of a robust boy whose cord had velamentous insertion and vasa previa. Baby ____'s water ruptured spontaneously just before contractions began at 40 weeks + six days gestation. During labor, we found Baby ____'s heart rate to be within normal range at every check and his birth progressed steadily. The second stage of labor went a little slower than it had in Mrs. ____'s previous birth, but Baby _____ was born with a nuchal cord and nuchal hand which possibly accounts for the slower progression of second stage.  He had Apgar scores of 7 and 9 at one and five minutes after birth. 

As we examined the placenta afterward, you can imagine our surprise to find ANOTHER velamentous insertion within a five month time frame...but more amazing was seeing how close to the vessels the fore waters had ruptured without damaging them. 

Praise God in His glorious grace and goodness!  I stand in awe of God's wisdom and might as I read Jeremiah 1:5 - Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee.... How near to demise Baby ____ could have come, yet he was divinely protected because he is here by the intended purpose of Almighty God!