Can placenta previa with the umbilical cord wrapped around the neck one time be delivered vaginally?

Written by Zhang Lu
Obstetrics
Updated on November 23, 2024
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Placenta previa and umbilical cord around the neck are two relatively common clinical conditions during pregnancy, and they have different impacts on natural childbirth. First, having the umbilical cord wrapped around the neck once is a very normal physiological occurrence, and it generally does not affect the ability to have a natural childbirth in any situation. Therefore, from the perspective of the umbilical cord around the neck, it does not affect natural childbirth. Second, placenta previa refers to the lower edge of the placenta being close to the internal os of the cervix. Whether natural childbirth is possible mainly depends on the type of placenta previa. If it is a partial or central placenta previa, such conditions generally cannot proceed with natural childbirth, as they might cause significant bleeding, necessitating an elective cesarean section. However, in the case of marginal placenta previa, where there is still some distance between the lower edge of the placenta and the cervical os, attempting natural childbirth might be possible, provided that preparations for a cesarean section are in place.

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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 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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Umbilical cord around the neck ultrasound manifestations

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 Du Rui Xia
Obstetrics
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How long should I wait before rechecking the ultrasound if the umbilical cord is around the neck?

When there is an occurrence of umbilical cord around the neck, it is generally recommended to have an ultrasound examination once every one to two weeks. Umbilical cord around the neck is a relatively common phenomenon during pregnancy, mostly due to the umbilical cord being too long, frequent fetal movements, and an excessive amount of amniotic fluid. These factors can cause the umbilical cord to wrap around the fetus's neck, and it may also wrap around the fetus's abdomen or limbs. Therefore, when umbilical cord entanglement occurs, it is important to enhance prenatal check-ups to regularly monitor changes in fetal heart rate and fetal movement. Additionally, towards the late stages of pregnancy, the appropriate method of delivery should be selected based on the specific circumstances of the umbilical cord entanglement.

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Written by Zhang Lu
Obstetrics
1min 6sec home-news-image

Can placenta previa with the umbilical cord wrapped around the neck one time be delivered vaginally?

Placenta previa and umbilical cord around the neck are two relatively common clinical conditions during pregnancy, and they have different impacts on natural childbirth. First, having the umbilical cord wrapped around the neck once is a very normal physiological occurrence, and it generally does not affect the ability to have a natural childbirth in any situation. Therefore, from the perspective of the umbilical cord around the neck, it does not affect natural childbirth. Second, placenta previa refers to the lower edge of the placenta being close to the internal os of the cervix. Whether natural childbirth is possible mainly depends on the type of placenta previa. If it is a partial or central placenta previa, such conditions generally cannot proceed with natural childbirth, as they might cause significant bleeding, necessitating an elective cesarean section. However, in the case of marginal placenta previa, where there is still some distance between the lower edge of the placenta and the cervical os, attempting natural childbirth might be possible, provided that preparations for a cesarean section are in place.