Can umbilical cord around the neck perform fetal position correction?

Written by Du Rui Xia
Obstetrics
Updated on September 04, 2024
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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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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 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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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 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 Zhang Yin Xing
Obstetrics
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How to prevent umbilical cord entanglement in late pregnancy

There are no effective prevention methods for nuchal cord, which is the most common form of umbilical cord entanglement where the cord wraps around the fetus's neck, limbs, or trunk. Nuchal cord occurs in 90% of these cases, frequently involving the cord wrapping around the neck once. This phenomenon can be observed in 20% of deliveries and is associated with factors such as an overly long umbilical cord, a small fetus, excessive amniotic fluid, and frequent fetal movements. An excessively long umbilical cord is mostly a physiological occurrence since the cord floats in the amniotic fluid and its actual length cannot be accurately measured, with no effective methods to prevent its occurrence. Excessive amniotic fluid and a small fetus are linked to certain pregnancy complications, such as diabetes-induced polyhydramnios and restricted fetal growth. Actively controlling blood sugar during pregnancy can prevent such issues. Frequent fetal movements are physiological for some pregnant women. Women who experience more frequent fetal movements throughout pregnancy are likely to encounter nuchal cord. Clinically, nuchal cord does not require special management unless it leads to obstructions in fetal descent, fetal distress, or variations in fetal heart rate. It does not impact delivery or fetal development.