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2 vessel cord

  Thank you for your earlier responses to the questions I have posted.
  I am 20 weeks pregnant and had my ultrasound earlier today. All her organs look great and her growth is perfect - I received the same due date from the ultrasound as expected from my lmp. She is proportioned appropriately. When checking for 3 vessels in the cord the sonographer could only find 2 but couldn't be certain there wasn't another one there. I go back in 2 weeks for another ultrasound. My question is what kind of birth defects could result if there are only 2 vessels? Do you know of any statisitics regarding the percentage of healthy babies born when the cord only contains 2 vessels? Is there any kind of intervention or should the baby's growth be monitored more closely if there are in fact only 2 vessels? Given that her organs and growth are all normal is it likely that there really is a third vessel that could not be seen on the image? I know this is a lot but I can't find any information on this. Do you know of any books, journal articles, web sites, etc where I could research the significance/impact of this?
  One other question. At 16 weeks her heartrate was 153 bmp. At 20 weeks, it was only 132 bmp. She was awake and very active when the ultrasound was taken. Is the drop of 21 bmp of concern or is it normal to fluctuate so greatly even though she was awake and active?
  Many thanks for you help.
Dear Tina:
A two-vessel cord identifies one artery and one vein, rather than 2 arteries and 1 vein, the expected 3-vessel cord. This variation is found in less than 1% of single babies and may be higher when there are twins. Most children, at least 70%, are normal. The problem with our statistics is that the reports of two vessel cords are more likely to be in association is an abnormal pregnancy: what we call, a bias of ascertainment.
A two vessel cord can be associated with a variety of organ-system and chromosomal abnormalities: the reassuring news for you is that all the organ systems are normally formed.
A two vessel cord can be associated with impaired growth as the pregnancy progresses: this is monitored by serial ultrasound studies to document the size/weight of the baby and biophysical profile (combines ultrasound measures with fetal heart rate patterns)to assure baby health.
The repeat study in two week will begin this monitor process.
References: any textbook of obstetrics: Williams Obstetrics for example. You will likely have to go to a medical school library or search a medical data base such as medline to find articles.
The normal fetal heart rate is 120 to 160 bpm. Your heart rate and mine also vary over a wide range depending on our activity, sleep/wake, food intake, hormone surges; the same thing happens with babies.
Keywords: 2 vessel umbilical cord
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please contact your physician.

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