FETAL UMBILICAL CORD PROBLEMS

Umbilical cord problems in pregnancy can cause stress for moms-to-be, but abnormalities
usually resolve themselves over the course of the baby's nine month gestation.

Posted by Bridget Coila | Last updated: Mar 25, 2013

An Umbilical Cord Knot in Early Pregnancy

Umbilical cord problems can be extremely scary to a pregnant woman. According to Dr.
Jason H. Collins at The Pregnancy Institute, umbilical cord accidents leading to stillbirth
occur in 1.5 of every 1000 births. An otherwise healthy fetus may suddenly develop a
problem with the umbilical cord that needs to be carefully watched to make sure it doesn’t
develop into an umbilical cord accident.

One problem seen with umbilical cords is an umbilical cord knot. These happen in early
pregnancy when the fetus has lots of room to move around in the amniotic sac. Sometimes,
the baby will move through a loop in the cord and accidentally pull on it, creating a knot
around the fetus. Umbilical cord knots are fairly common.

While there is nothing that can be done to prevent or fix an umbilical cord knot, doctors will
often monitor the situation to determine if the knot tightens. In that case, early delivery may
be recommended if the baby is found to not be getting enough nutrients or seems to be
suffering from fetal distress. If the knot stays loose, it is not considered dangerous for the
baby.

If signs of distress appear during labor, such as blood flow to the baby slowing down or the
fetal heartbeat becoming abnormally fast or slow due to the umbilical cord knot tightening,
the doctor may perform a C-section or monitor the baby carefully to see if the situation
improves.

The Nuchal Cord- An Umbilical Cord Around the Neck

Sometimes the umbilical cord can get wrapped around the baby's neck in utero. This is called
a nuchal cord or nuchal loop. Nuchal loops are one of the most common umbilical cord
problems in late pregnancy, occurring in about 25% of all births, according to the March of
Dimes. A nuchal cord can lead to stillbirth if the doctor or midwife is not aware of the issue
before labor begins.

Fortunately, with modern ultrasound technology and fetal monitoring, doctors and midwives
can see if the umbilical cord is wrapped around the neck ahead of time and can prepare for it.

The solution is often a simple one. The doctor simply slips a finger between the cord and the
neck during birth in order to prevent the newborn baby from being strangled and then
untangles the cord and slips it over the baby's head once the head is out of the birth canal.

A nuchal cord wrapped around other parts of the baby, such as the hand or foot, generally
don't cause any problems, either prenatally or during birth.

Umbilical Cord Knots and Wrapping in Early Pregnancy

In early pregnancy, these issues are unlikely to be a problem. Umbilical cord twisting and
wrapping is a common occurrence in early pregnancy, since the fetus is so small that it easily
moves around in the womb. Any knots or wrapping at this point are likely to resolve
themselves as the baby moves around and unwraps itself.
If the doctor detects low levels of fluid in the amniotic sac, this could indicate a higher
likelihood of developing potential umbilical cord problems, since less fluid gives the baby
less room to untangle from any knots or loops that might have formed. Proper hydration helps
keep fluid levels high, so drinking lots of water is the only real prevention for this kind of
problem.

Overall, fetal umbilical cord problems are not something for a pregnant woman to worry too
much about unless her doctor is concerned. Umbilical cord accidents in the fetus are rare and
as long as proper prenatal care is given, doctors can intervene in any potential umbilical cord
problems during labor.