Shell attaching the umbilical cord (insertio funiculi umbilicalis velamentosa)

Frequency shell attach the cord, according to different authors, varies in the range of 0.5-0.8%; according to the observations I. I. Rusin, it is 1.1%. These figures are insignificant; in practice, this complication occurs much more often.
Usually the umbilical cord is attached to the placenta and only in rare cases - to shells. When shell attaching umbilical vessels at a certain course are outside the placenta tissue between water and fleecy shells. If the site intermembranous vessels which is at the lower pole of the eggs at the time of rupture of the membranes of the integrity of the blood vessels can be broken and bleeding occurs. The fruit losing blood, and if it is not immediately removed, then, as a rule, quickly perishes. Unfortunately, about the possibility of such complications is often overlooked.
However, fetal loss can occur from asphyxia on the soil compression of a gleam of vessels moving fetus's head after rupture of membranes. The only indication of the possibility of such complications can be Taikov and thickening on the lower pole of the ovum, defined during vaginal examination. The presence of Taikov and thickening should direct the thought of the doctor on the possibility of branching of the shell is attached vessels of the umbilical cord (S. N. Davydov).
Shell attaching the umbilical cord is accompanied by a small number of Vartanova studeni in it and the weak development of fibrous connective tissue, which helps to break the umbilical vessels and easily compressed.
Due to incorrect insertion of the umbilical cord and inferiority of its vessels, the blood supply of the fetus is often disrupted and children are born with low weight. Rupture of blood vessels of the umbilical cord represents a serious threat to the life of the fetus, for bleeding occurs only from his body; his mother from bleeding absolutely not suffer, so as not to lose blood.
Shell attaching the umbilical cord, apparently, develops depending on the nature of the attachment of the vessels of the allantois. In the early stages of prenatal development of the vessels of the allantois can grow into the uterine lining in any part of the chorion. Depending on the place of incarceration (decidua serotina, reflexa) occurs normal or wrong (shell) attach the cord. However, shell enlisting in the development process can become normal. This is because the accumulation of water amnion more and more detached from fruit, squeezes still divergent education (allantois, umbilical vessels and vitelline duct included later in the composition of the umbilical cord) and came closer to CVS. Coming on the third month of pregnancy division chorion frondosum et chorion laeve leads to "shift" amnion and umbilical vessels to chorion frondosum.
In those cases, when such a shift is impossible due to the increment of umbilical vesicle to the chorion, occurs shell attaching the umbilical cord (I. I. Rusin).