Should You Worry About Nuchal Cords?

No one likes to think about the complications that occur during pregnancy. However, umbilical cord around your baby's neck happens. Should it be a concern then?

When the umbilical cord becomes wrapped 360 degrees around the neck of your baby, it is known as a nuchal cord. Nuchal cords are quite common—between 6% and 37% of babies will experience a nuchal cord at some point during their time in the womb. As many as half of all nuchal cords will resolve before the baby is delivered. Nuchal cords can occur in one of two ways. “Type A” nuchal cord occurs when the umbilical cord wraps 360 degrees around a baby’s neck; “Type B” nuchal cord “hitches” so that it is unable to be undone and therefore ends up as a true knot.

Umbilical Cord Around Neck: Should I Be Worried?

Typically, umbilical cord around a baby’s neck is not diagnosed until your baby is being delivered; thus, there is no way to predict or suspect a nuchal cord. Nevertheless, the very idea of your baby being “strangled” by the umbilical cord can cause an immense amount of stress and worry. Thankfully, a normal, healthful umbilical cord is protected against the compression of blood vessels. The umbilical cord delivers both nutrients and oxygen to the baby, so there is no need for babies to breathe in through their noses and mouths. Of course, this also means that babies do not need their necks to breathe, so the chances of nuchal cords causing serious damage to a baby is actually very slim.

Most of the time, a nuchal cord will pass unnoticed and without issue during your baby’s birth. If your midwife happens to find that the umbilical cord is wrapped around your baby’s neck after his head has been born, the situation is easy for her to fix. She will simply loosen the umbilical cord so that your baby’s shoulders are able to pass through it, or she will just slip the cord over his head. Well, you will likely be too busy pushing to notice any issues!

There are only two rare cases in which umbilical cord around neck can be cause for concern:

  • If the cord has wrapped very tightly around the baby’s neck
  • If something is obstructing the flow of blood through the cord

If the cord is wrapped tightly around your baby’s neck, your midwife could decide to clamp and cut the cord before your baby’s shoulders are born. This situation is highly unusual.

Your baby’s heart rate will be able to tell your midwife whether there are any issues with the flow of blood in the umbilical cord. Sometimes during a contraction, the umbilical cord may be compressed, which can result in your baby’s heart rate decreasing for a moment.  If your midwife suspects that this is the situation, she will more closely monitor your baby’s heartbeat. As long as she does not notice any other problems, your labor will continue without intervention. Try not to worry! Complications such as these are rare. Your midwife will explain the entire process to you and your partner.

If There’s Problem in Delivery

If your vaginal delivery is prolonged so that it threatens the health, safety, or even the life of your baby, an emergency C-section will be performed. Delaying an emergency C-section may severely exacerbate the already detrimental effects of ischemia and hypoxia, which can lead to serious brain injuries.

Your physician and his medical team need to be very knowledgeable and skilled in handling any issues that may arise during labor and delivery that many deprive your baby of oxygen and blood. It is imperative that the medical team is able to act quickly. If they fail to properly monitor or treat the mother and her baby during pregnancy or delivery, they are guilty of negligence.

Other Possible Complications

Some other issues with the umbilical cord may cause complications. These include cord prolapse and cord compression.

  • Cord prolapse happens when the umbilical cord enters the vagina (birth canal) when the baby is behind it. This can quickly lead to an emergency situation, as the blood flow of the cord is often pinched off because it is pressed between the body and head of the baby. A baby who experiences a cord prolapse will typically require an emergency C-section.
  • Cord compression occurs when the umbilical cord becomes pressed between the baby and the pelvis to the extent that some disruption begins to occur. This can sometimes be alleviated by having the mother change position—even just rolling from her left side to her right side. Sometimes, other intervention may be necessary, such as oxygen for the mother or amnioinfusion, which is a process where fluid is put back into the uterus so that both the baby and the umbilical cord have enough cushioning. If the fluctuations in the baby’s heartbeat are particularly severe or do not seem to be responding to treatment, an emergency C-section will likely be necessary.

Umbilical Cord Around Neck: Can I Prevent It?

There is no way in which you can prevent your umbilical cord from wrapping around your baby’s neck. Your baby will move a lot in the womb; during your pregnancy, the cord will become wrapped and unwrapped many times. The “cord accidents” that happens when the cord becomes too twisted around your baby are extremely rare.

Risk factors for this condition:

  • Abnormal presentation during birth (i.e. breech or shoulders first)
  • Hydramnios (too much amniotic fluid surrounding the baby)
  • Nutritional deficiencies that affect the structure and protective barrier of the umbilical cord
  • Multiple babies in the womb
  • Large gestational age
  • An especially lengthy umbilical cord

Umbilical Cord Around Neck: What Others Have Experienced

“My second child had his cord wrapped 3 times around his neck. I did have him vaginally, but the doctors didn’t know about the cord beforehand. If they had, they may have suggested a C-section. My son was fine, but it took him a minute to cry! Babies with nuchal cords can be delivered vaginally, but your doctor may have a good reason for suggesting a C-section. You’ll want to do whatever is best for the baby. If you are uncomfortable with your doctor’s opinion, it’s fine to get a second opinion before you officially decide. Just make sure to play it safe!”

 “I am a pregnant woman now into my 37th week. During my scan, my doctor noticed that my baby’s umbilical cord was wrapped twice around his neck. My doctor is now suggesting that I keep a very close eye on my baby’s movements—I need to know what he’s doing all day and all night. She warned that I need to consult her immediately if I feel my baby moving less than he normally does.”

“My advice is to monitor your baby very carefully. Be sure to listen to everything your doctor advises. If you do end up having a C-section instead of a vaginal delivery, you can’t be too hard on yourself. Your baby’s safety is the most important thing. I thought I was having a perfect pregnancy, but 2 days before my due date I stopped feeling my baby move. My doctor monitored me for a couple hours before deciding I needed an emergency C-section. My baby’s cord was wrapped 3 times around her neck—they could barely push her out of the incision they made in my uterus. My daughter needed CPR. She had a collapsed lung and had multiple seizures on the day that she was born. I don’t want to scare anyone; I just want to convey the importance of keeping track of your baby’s movements and of trusting your doctors rather than sticking rigidly to a birth plan that may not turn out exactly as expected. After two weeks in the NICU, my baby girl is now perfectly healthy, but it was definitely a scary experience!”



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