Velamentous insertion of the umbilical cord and vasa previa.

We report 31 cases with velamentous insertion of the umbilical cord of whom two had coexistent vasa previa. The prevalence of the former was 0.22% and of the latter 0.014%. Perinatal mortality was low, 3.2%, but there was a high rate of complications during pregnancy, such as threatened abortion, antepartum and intrapartum bleeding, premature delivery and fetal distress. Fifteen patients underwent caesarean section. Four of the term infants were small for gestational age. One infant had congenital malformations. The two cases with vasa previa are described in detail. We conclude that velamentous insertion of the umbilical cord should be kept in mind in the differential diagnosis of fetal distress accompanied with antepartum or intrapartum vaginal bleeding.