Why doesn't the ultrasound show the umbilical cord around the neck?

Written by Du Rui Xia
Obstetrics
Updated on September 04, 2024
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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.

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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?

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.

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Written by Du Rui Xia
Obstetrics
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Can ultrasound detect nuchal cord?

During the color ultrasound examination, it is possible to detect whether the fetus is experiencing umbilical cord entanglement around the neck. If the ultrasound shows a V-shaped echo around the fetal neck, it generally indicates that the umbilical cord is wrapped around once. If the echo is W-shaped, then the cord is wrapped twice. If the cord is wrapped multiple times, the echo will appear serrated. Additionally, the color ultrasound can also assess the blood flow around the umbilicus to determine the presence of umbilical cord entanglement. If cord entanglement is detected, it is recommended to have regular ultrasound check-ups at the hospital to monitor the fetus's safety in the uterus.

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Written by Du Rui Xia
Obstetrics
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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.

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Written by Du Rui Xia
Obstetrics
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Can the umbilical cord unwrap itself after it has wrapped around the neck and entered the pelvis?

When the fetus has already engaged and there is nuchal cord occurrence, it is generally unlikely for the wrapping to unwind again. This is because once the fetus has engaged, the fetal position is fixed, and the fetus will no longer change its position, making the nuchal cord a more fixed condition. When dealing with nuchal cord, it is important to observe the number of loops and whether the tightness of the loops could impact the fetus. Therefore, it is necessary to regularly attend prenatal appointments at the hospital to monitor its developmental condition. If the nuchal cord loops just once around the neck, it usually does not affect the baby.

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Written by Du Rui Xia
Obstetrics
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The difference between U-shaped and W-shaped nuchal cords.

During pregnancy, through ultrasound examination, if echoes of the umbilical cord are found around the fetus’s neck in U-shaped or W-shaped patterns, this indicates the presence of nuchal cord. The difference between U-shape and W-shape primarily lies in the number of wraps around the neck. A U-shaped notch indicates the umbilical cord is wrapped around the neck once; a W-shape indicates it is wrapped twice. When nuchal cord is present, there is no need to be overly anxious; regular prenatal check-ups can be conducted at the hospital to monitor the development of the nuchal cord and the safety of the fetus inside the uterus.