Is “Nuchal Cord” — Umbilical Cord Wrapped Around the Neck — Dangerous?

When attending prenatal check-ups, some mothers-to-be might discover the umbilical cord is wrapped around the baby’s neck. This often triggers immediate concern. The thought of the baby being deprived of oxygen or the possibility of a mandatory cesarean delivery can be nerve-wracking. However, it’s essential to know that not all umbilical cord wraps pose a danger, and contemporary medicine provides viable solutions.

The Active Fetus

As the baby grows, it moves actively within the womb, turning and twisting. In this limited space, the umbilical cord may become entangled around various parts of the baby, including the neck, torso, arms, or legs. Sometimes, even if the fetus has been free from cord entanglement, it might become tangled in the final weeks of pregnancy. Conversely, an initially tangled cord could unravel on its own before labor begins.

Ultrasound Provides Insights

Typically, if an ultrasound reveals a U-shaped indentation on the fetus’s neck, it might indicate the umbilical cord is wrapped around it. A color ultrasound can show the direction of the blood flow through the umbilical cord, helping to determine the number of times the cord is wrapped and gauge the cord’s length. Consequently, ultrasound remains the primary method to diagnose and monitor cord wrapping. Additionally, fetal heart monitors can detect cord entanglements early on.

Not Necessarily Harmful

Umbilical cord wrapping is relatively common. It occurs in 1 out of every 3 to 5 pregnancies. Fortunately, the umbilical cord is elastic, and its blood vessels, which are coiled and stretchy, are typically longer than the cord itself. As long as the cord isn’t stretched too tight, affecting its blood flow, most babies remain unaffected even if wrapped. For instance, babies with a longer umbilical cord (more than 70 centimeters) might not face issues even if wrapped for a couple of weeks. However, if the cord is too short (less than 30 centimeters), potential risks can arise during delivery, even without wrapping.

Electronic fetal monitoring during the latter stages of pregnancy and labor can provide insight into how the wrap might be affecting the baby. Obstetricians can use this information to make informed decisions. If there are complications or abnormal fetal heartbeat, a cesarean section might be chosen. Otherwise, if labor progresses well and the baby’s heart rate remains steady, a vaginal delivery can take place. In such cases, it’s crucial to expedite delivery, ensure the cord is loosened promptly, and, if required, provide surgical assistance.

Staying Vigilant

If the baby continues to move actively, there’s no need for excessive worry upon discovering a cord wrap. As the fetus moves, the tangled cord might resolve on its own. The best approach upon discovering a wrap is to attend regular check-ups, heed medical advice, and consider a cesarean if deemed necessary. Since this condition can be deemed high-risk, expecting mothers should be proactive. A potential oxygen deprivation can endanger the baby. To ensure both mother and baby’s safety, early hospitalization, monitoring via fetal heart monitors and ultrasounds, and staying prepared for delivery is crucial.