What should I do if the fetal umbilical cord is wrapped around the neck once?

Written by Zhang Lu
Obstetrics
Updated on September 17, 2024
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During the prenatal ultrasound, it is sometimes discovered that the umbilical cord is wrapped around the fetus's neck, which concerns many pregnant women who fear it may cause fetal hypoxia in utero or affect natural childbirth. However, this concern is not accurate. Currently, in clinical practice, an umbilical cord around the neck is considered a normal physiological phenomenon. Around 30%-40% of fetuses may have the umbilical cord wrapped around their neck. It is acceptable for the umbilical cord to be wrapped around the neck once or twice, as this neither impacts the fetus's oxygen levels nor affects the mode of childbirth; natural birth can still be considered. Therefore, when the umbilical cord is wrapped around the neck once, no intervention is required. Follow the normal prenatal check-up routine and pay attention to fetal movements in daily life. As long as the fetal movements are normal, it indicates that the fetal condition in the uterus is good.

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Written by Du Rui Xia
Obstetrics
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The difference between a V-type and U-type nuchal cord.

When umbilical cord entanglement occurs, ultrasound examination may reveal a U-shaped or V-shaped entanglement. The V-shape and U-shape both indicate that the umbilical cord is wrapped around the neck once. In such cases, there is no need for excessive anxiety. Sometimes the cord may unwind by itself as the fetal position changes, loosening or alleviating the entanglement. It is important to regularly visit the hospital for prenatal check-ups, rest adequately, enhance nutrition, and adopt a left lateral position to improve placental blood supply.

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Written by Du Rui Xia
Obstetrics
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How to count fetal movements when the umbilical cord is wrapped around the neck

When there is nuchal cord presence, it is important to determine the number of loops around the neck as well as the tightness of the loops, to assess if they might affect the fetal heart rate. Generally, nuchal cords do not impact fetal blood circulation, so fetal movement can still be measured normally. Proper measurement should be taken at fixed times each day: morning, noon, and evening—for example, at 7 AM, 12 PM, and 9 PM respectively. During each of these times, select one hour when you can calmly and attentively feel and count the baby’s movements in a quiet setting, and record the number of movements.

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Written by Liu Wen Li
Obstetrics
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What should I do if the umbilical cord is wrapped around the neck once during the mid-pregnancy?

The incidence of the umbilical cord wrapping around the neck once is quite high, accounting for about one-fifth of pregnant women. Generally, if the umbilical cord is loosely wrapped around the child's neck, and if the cord is long enough, it usually does not have a significant impact on the fetus. However, if the umbilical cord is tightly wrapped around the neck, and additionally, if the cord is relatively short, it can sometimes lead to pulling and thinning of the cord, causing obstruction in the blood vessels within the cord. This can result in oxygen deficiency for the baby. Therefore, during the mid-pregnancy period when umbilical cord entanglement occurs, it is important to enhance monitoring. Regular prenatal check-ups, counting fetal movements by oneself, and frequent monitoring of fetal heart rate changes are advisable.

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Written by Du Rui Xia
Obstetrics
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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.

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Written by Zhang Lu
Obstetrics
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Is it dangerous for the umbilical cord to be wrapped around the neck during the mid-stage of pregnancy?

During a mid-pregnancy ultrasound, it is sometimes indicated by the presence of a U-shaped or W-shaped notch behind the fetus's neck that the fetus may have the umbilical cord wrapped around its neck. During pregnancy, it is perfectly normal for the umbilical cord to wrap around the neck, and it generally does not affect the fetus or pose any danger. The length of the umbilical cord during pregnancy is approximately 30 to 80 centimeters, which is quite long relative to the size of the uterine cavity. Hence, many umbilical cords have excess length that can wrap around the neck or limbs of the fetus, leading to the umbilical cord being coiled around the neck or limbs. However, current research indicates that whether the umbilical cord is wrapped around the neck or limbs once or twice, it does not affect the fetus. It does not cause intrauterine hypoxia or affect the growth and development of the fetus, nor does it influence the mode of delivery. A natural childbirth can still be an entirely viable option.