Can ultrasound detect nuchal cord?

Written by Du Rui Xia
Obstetrics
Updated on September 19, 2024
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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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Does the umbilical cord wrapping always involve the neck?

Umbilical cord entanglement around the neck usually occurs during the mid-pregnancy period, as this is when the baby moves more frequently. The baby has a larger range of movement within the uterine cavity, which can easily lead to the cord wrapping around the neck, abdomen, legs, or arms. Generally, if there is no cord entanglement found after 32 weeks of pregnancy, it is unlikely that it will occur. However, this is not certain. After the baby engages, which is after 35 weeks, the baby's position becomes fixed, and it is unlikely for cord entanglement to occur thereafter.

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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 Zhang Yin Xing
Obstetrics
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What should I do if the umbilical cord is wrapped around the neck once?

Umbilical cord wrapping around the neck once is a very common phenomenon, occurring in 20% of fetuses. When the umbilical cord wraps around the neck once, if the umbilical blood flow and fetal movements are normal, it indicates that the cord wrapping does not affect the fetus and will not have a direct impact on the fetus's intrauterine growth and development. However, during childbirth, attention must be paid to the possibility that the umbilical cord wrapping may cause difficulties in the descent of the presenting part of the fetus, leading to abnormal umbilical blood flow. If difficulties in the descent of the presenting part and changes in the fetal heart rate occur during delivery, the possibility of umbilical cord wrapping should be considered. If necessary, a cesarean section should be performed to terminate the pregnancy. There are no medications or other treatments that can alleviate umbilical cord wrapping; instead, enhanced prenatal monitoring is sufficient.

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Written by Zhang Lu
Obstetrics
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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.

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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.