Can the umbilical cord unwrap itself after it has wrapped around the neck and entered the pelvis?

Written by Du Rui Xia
Obstetrics
Updated on September 18, 2024
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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 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 umbilical cord around the neck require a B-ultrasound recheck?

When there is a situation of umbilical cord around the neck, pregnant women need to regularly visit the hospital for an ultrasound checkup to understand the condition of the umbilical cord entanglement, mainly to monitor the umbilical blood flow. If there is an increase in umbilical blood flow, it indicates that the cord entanglement is tight, which can affect the baby's safety, potentially leading to lack of oxygen or suffocation. Therefore, in the late stages of pregnancy, it is also necessary to go to the hospital every 3-7 days for fetal heart monitoring to check if there is any lack of oxygen in the fetus while inside the womb. If there is fetal hypoxia in the late stages of pregnancy, it is advisable to terminate the pregnancy in a timely manner.

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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 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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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.