title: Velamentous cord insertion and atypical variable decelerations with no accelerations.
abstract: OBJECTIVE
  To examine intrapartum fetal heart rate (FHR) patterns in the presence of velamentous cord insertion (VCI).
  
  
  METHODS
  The site of cord insertion was determined in 1460 women on antenatal ultrasonographic and postnatal examinations. Each of 24 women with pregnancies complicated with VCI was matched at the onset of labor with 10 women who had a normal pregnancy, and FHR patterns were analyzed for both cases and controls.
  
  
  RESULTS
  Compared with controls, cases of variable decelerations with no accelerations (VDNA) during the first and second stages of labor were more frequent in women with VCI (first stage: 25% vs. 5.1%, second stage: 65.0% vs. 21.7%, P < 0.001). The adjusted odds ratio associated with VDNA occurrence in women with VCI was 3.83 (95% confidence interval [CI]: 1.51-9.72, P = 0.005). The mean odds ratio associated with length of aberrant vessels in women with VCI plus VDNA was 1.38 (95% CI: 1.04-1.83, P = 0.026).
  
  
  CONCLUSIONS
  Pregnancies complicated with VCI are associated with a higher rate of VDNA.
authors.affiliation: Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. hasejun@oak.dti.ne.jp
authors.forename: J
authors.initials: J
authors.lastname: Hasegawa
authors.forename: R
authors.initials: R
authors.lastname: Matsuoka
authors.forename: K
authors.initials: K
authors.lastname: Ichizuka
authors.forename: A
authors.initials: A
authors.lastname: Sekizawa
authors.forename: A
authors.initials: A
authors.lastname: Farina
authors.forename: T
authors.initials: T
authors.lastname: Okai
mesh_terms: D000328:Adult; D001919:Bradycardia / Q000175:diagnosis* / Q000196:embryology / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007747:Labor Stage, First; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000002:abnormalities* / Q000000981:diagnostic imaging