How to count fetal movements when the umbilical cord is wrapped around the neck

Written by Du Rui Xia
Obstetrics
Updated on March 12, 2025
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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 Du Rui Xia
Obstetrics
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What will the fetal movement be like if the umbilical cord is wrapped around the neck?

Generally, when the umbilical cord is wrapped around the neck, it often does not affect the fetal movement or fetal heart rate changes. It is quite common for the cord to be wrapped around once, and if the wrapping is loose and does not affect the blood supply from the placenta, fetal movement will not change. However, if the cord is tightly wrapped multiple times, it can affect the blood supply of the umbilical cord and impact the fetal blood circulation, leading to frequent fetal movements. Therefore, pregnant women should learn to count fetal movements themselves to understand if the fetus is experiencing hypoxia in the womb.

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

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 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.

doctor image
home-news-image
Written by Du Rui Xia
Obstetrics
45sec home-news-image

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.