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Nuchal Cord
What should I do if the umbilical cord is wrapped around the neck?
Umbilical cord entanglement around the neck is a common complication for pregnant women. It mostly occurs with the umbilical cord wrapped around the neck once, accounting for about 20% of all deliveries, which means that 1 in 5 pregnant women will experience this condition. The main danger of umbilical cord entanglement is that if the cord is wrapped tightly or is short, it can pull on the cord during pregnancy or delivery, causing the blood vessels within the cord to constrict. This constriction can decrease the fetal blood circulation, leading to fetal distress, which is characterized by changes in fetal heart rate and fetal movement. Therefore, if there is umbilical cord entanglement, it is important to enhance monitoring during pregnancy and delivery. If fetal distress or fetal hypoxia occurs, a cesarean section should be performed promptly to terminate the pregnancy.
What to do if the umbilical cord is wrapped around the neck once in late pregnancy?
During the late stages of pregnancy, a B-ultrasound might sometimes reveal that the fetus has the umbilical cord wrapped around its neck once. This condition is a physiological occurrence. Having the cord wrapped once around the neck does not cause intrauterine hypoxia or harm the growth and development of the fetus inside the womb. The vast majority of cases where the cord is wrapped are physiological, and whether the cord is wrapped around once or twice, there is no need for excessive worry. In the late stages of pregnancy, the most important thing when the cord is found wrapped around the neck is to monitor fetal movements. As long as the fetal movements are good, it indicates that the fetus is in a normal condition inside the womb. It is also important to keep up with regular prenatal check-ups to assess whether the fetal growth and development are normal. Additionally, it is not advised to take any action to intervene when the cord is wrapped around the neck, as neither adopting sleeping positions nor any other methods can release the cord from the neck. These methods are futile and sometimes might even harm the fetus.
Can nuchal cord be corrected by lying prone?
Nuchal cord refers to a condition during pregnancy where the umbilical cord wraps around the fetus's neck or abdomen due to the baby's continuous movements and changes in position. Lying prone cannot correct a nuchal cord because the fetus can move freely within the womb. In some cases, the baby may even resolve the issue through its movements, so there is no need for excessive worry. It is only necessary to visit the hospital regularly for prenatal check-ups, follow the doctor's advice, and monitor the fetal heart rate. Generally, this does not cause any adverse effects.
Umbilical cord around the neck ultrasound manifestations
The impact of umbilical cord entanglement on the fetus is quite significant. If the entanglement is excessive and tight, it can lead to fetal hypoxia. Generally, fetuses with the umbilical cord wrapped around the neck once or draped on the neck do not show clinical symptoms. However, if the entanglement is tight, it can jeopardize fetal health. During an ultrasound examination, echoes can be seen on the fetus's neck where the umbilical cord is wrapped, and distinct pressure marks may appear on the skin. A single wrap around the neck appears as a U-shape, two wraps appear as a W-shape, and three wraps as a serrated shape.
Does an umbilical cord around the neck always require a cesarean section?
When nuchal cord occurs, it is not always necessary to perform a cesarean section, because sometimes the cord may be loosely wrapped around, even if only for one loop, and in such cases, natural childbirth is still possible. However, if the nuchal cord is wrapped more than two or three times, and is tightly wrapped, and if there is fetal hypoxia inside the uterus, then a cesarean section must be performed to quickly terminate the pregnancy. Nuchal cord is a common cause of difficult labor in pregnant women. Therefore, during the later stages of pregnancy, regular prenatal check-ups should be carried out to monitor the fetus's health. If any abnormalities are detected, it is urgent to admit to the hospital for delivery to avoid potential impacts on the baby, such as hypoxia or asphyxiation.
Can you have a vaginal birth if the umbilical cord is wrapped around the neck once?
Umbilical cord wrapping is a common physiological phenomenon during pregnancy, mainly because the length of the umbilical cord during pregnancy generally ranges from 30cm to 80cm, which far exceeds the length needed for fetal growth and development. Therefore, occurrences like the umbilical cord wrapping around the neck or limbs are quite normal. An umbilical cord around the neck is not an indication for cesarean section, and a vaginal delivery is entirely feasible, even if the cord wraps around the neck once or even twice. However, due to the special circumstance of the umbilical cord being wrapped around the neck, it is crucial to pay attention during the delivery process. First, it is important to monitor the fetal heart rate closely, as umbilical cord wrapping can lead to fetal hypoxia, which would be indicated by changes in the fetal heart rate. Second, preparations for an emergency cesarean section should be in place in case of an abnormal fetal heart rate, at which point a cesarean may be necessary to terminate the pregnancy.
How to correct nuchal cord with one loop?
Nuchal cord occurs because the fetus moves frequently within the uterine cavity, which can result in the umbilical cord looping around the neck once, referred to as a single-loop nuchal cord. In fact, it is not correctable because it is impossible to physically reach the umbilical cord or the fetus during pregnancy. Moreover, a single-loop nuchal cord is quite common, occurring in about one-fifth of all pregnancies. If the loop is loose or the umbilical cord is sufficiently long, there is generally no significant impact on the baby. However, if the loop is tight, it can pull on the umbilical cord, causing the blood vessels within the cord to narrow. This may lead to noticeable changes in fetal movements and heart rate. Therefore, with a nuchal cord, it is important to enhance monitoring and pay attention to changes in fetal movements and heart rate.
Why doesn't the ultrasound show the umbilical cord around the neck?
Generally, in cases where there is umbilical cord entanglement around the neck, it can be detected through an ultrasound examination. However, if the ultrasound does not show the umbilical cord wrapped around the neck, it is possible that the cord moved back around as the fetus moved during pregnancy. It might also be that the cord is not fully wrapped around the fetus's neck, but rather draped over the shoulder or neck. This situation could also relate to the fetal position, making it undetectable.
Can umbilical cord around the neck perform fetal position correction?
In cases of nuchal cord, it is not advisable to attempt correcting abnormal fetal positions, because if the fetal position changes abnormally after an attempted correction while the umbilical cord is wrapped around the neck, it may worsen the degree of the nuchal cord, potentially leading to fetal hypoxia or even asphyxiation. However, if the umbilical cord is relatively long, it might not affect the changes in fetal position, and sometimes the fetus can automatically free itself from the nuchal cord through its own movements. It is important to regularly visit the hospital for prenatal check-ups to detect any other potential abnormalities.