The difference between U-shaped and W-shaped nuchal cords.

Written by Du Rui Xia
Obstetrics
Updated on December 11, 2024
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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 Liu Wen Li
Obstetrics
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How to correct nuchal cord with one loop?

Nuchal cord occurs because the fetus moves frequently within the uterine cavity, which can result in the umbilical cord looping around the neck once, referred to as a single-loop nuchal cord. In fact, it is not correctable because it is impossible to physically reach the umbilical cord or the fetus during pregnancy. Moreover, a single-loop nuchal cord is quite common, occurring in about one-fifth of all pregnancies. If the loop is loose or the umbilical cord is sufficiently long, there is generally no significant impact on the baby. However, if the loop is tight, it can pull on the umbilical cord, causing the blood vessels within the cord to narrow. This may lead to noticeable changes in fetal movements and heart rate. Therefore, with a nuchal cord, it is important to enhance monitoring and pay attention to changes in fetal movements and heart rate.

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Written by Du Rui Xia
Obstetrics
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Can I walk for an hour after meals if the umbilical cord is wrapped around the neck?

In cases where there is umbilical cord entanglement around the neck, as long as the baby's fetal heart rate and fetal movement checks are normal, the mother can normally go for a walk after meals. This condition will not affect the fetus. It is important to regularly visit the hospital for fetal heart monitoring and prenatal examinations, pay attention to observing changes in fetal movement inside the womb, and avoid doing overly heavy or intense exercises. If any abnormalities in fetal movement or heart rate are observed, it is necessary to go to the hospital for examination. When needed, oxygen intake and treatments to preserve the pregnancy might be required.

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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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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 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.