Umbilical cord around the neck ultrasound manifestations

Written by Du Rui Xia
Obstetrics
Updated on September 13, 2024
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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.

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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.

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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.

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Written by Du Rui Xia
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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 Zhang Lu
Obstetrics
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What should I do if the fetal umbilical cord is wrapped around the neck once?

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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Will there be changes in the fetal heart rate if the umbilical cord is wrapped around the neck?

When the umbilical cord is wrapped around the neck, there are some situations where changes in the fetal heart rate may occur. The umbilical cord is mostly wrapped around the neck just once, which generally does not affect the growth and development of the fetus, nor does it significantly change the fetal heart rate. The impact on the fetal heart rate in the case of nuchal cord depends on how tight the cord is wrapped around the neck, the number of loops, and the length of the umbilical cord, among other factors. If the umbilical cord is tightly wrapped and has multiple loops, or if it is compressed due to contractions of the uterus, it can obstruct fetal blood circulation and lead to hypoxia in the fetus, thereby affecting the fetal heart rate.