Objective  To investigate the effect of velamentous umbilical cord insertion(VCI)on the outcome of perinatal infants and the clinical strategies for the management of VCI.

  Methods  The clinical data of 53 VCI patients (VCI group) were retrospectively analyzed, and 17 877 non-VCI patients were included in the non-VCI group. The influence of VCI and prenatal VCI on perinatal outcomes was analyzed. The causes of poor perinatal prognosis of VCI were summarized.

  Results  The incidence rates of fetal growth restriction, stillbirth, premature delivery and cesarean section in the VCI group showed significant differences compared with those in the non-VCI group(P < 0.05). The perinatal prognosis of the VCI group was worse than that of the non-VCI group, and the difference was statistically significant (P < 0.05). Of the 53 VCI perinatal births, three died (dilivered by patients diagnosed with VCI after birth), including 1 with rupture of anterior vessel (VP), 1 with umbilical cord torsion, and 1 with placental abruption. Of the 53 patients with VCI, thirty-one were confirmed by prenatal ultrasound, and 21 of them were detected by ultrasound at 18 to 24 weeks of gestation; eight cases were detected by ultrasonography at 25 to 35 weeks of gestation; two cases were found by ultrasound after 36 weeks of gestation.

  Conclusion  The incidence of VCI in pregnant women is low, but it can lead to adverse perinatal outcomes. The detection rate of VCI ultrasonography in early pregnancy is higher, and definite prenatal diagnosis can improve perinatal prognosis.