Prenatal ultrasound examination was powerful to detect abnormal umbilical cord insertion as well as fetal anomaly. Here a case of abnormal umbilical cord insertion like vasa previa is presented.
Case: A 28 years-old primigravida patient was found abnormal cord insertion since GA 20+ weeks. The placenta was anterior low-lying with marginal cord insertion. The cord insertion site was just above the internal cervical opening. It was uneventful during the whole prenatal supervision. Since 28 week of gestation, the fetal growth was found a little behind normal growth curve by 2 weeks. The fetal presentation was always vertex. However, one loop of umbilical cord was kept the position just in front of fetal head all the time. Like vasa previa, she was arranged for elective cesarean section at 37.1 week of gestation for fear of cord broken by the pushing forward of fetal head. The BBW was 2556gm and the Apgar scale was 8-8. The development of the baby was normal so far, 3 months after the cesarean section.
Conclusion: It is necessary an adequate prenatal care, diagnosis and elective management, to avoid the mobility and mortality due to abnormal placentation like vasa previa. However, the abnormal cord insertion like this is also need proper attention to prevent fetal exsanguination resulting from cord vessels broken when the fetal head push downward.