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Nuchal Cord
Is moxibustion useful for breech presentation and nuchal cord?
Fetal breech presentation and nuchal cord can be effectively addressed with moxibustion. Breech positions are common in early pregnancy but typically resolve to a head-first position by 32 weeks and become relatively stable. Higher incidences of breech positions are noted in cases of fetal abnormalities, twin pregnancies, abnormal amounts of amniotic fluid, uterine abnormalities, and narrow pelvis. If a breech position is still present after 32 weeks, moxibustion treatment can be considered. Moxibustion is applied at the Zhiyin acupoint (located 0.1 inches beside the nail corner on the outer side of the little toe) and is generally recommended once daily for 15 to 30 minutes, with one week constituting a treatment course. Afterward, the improvement in the fetal position can be evaluated. The purpose of using moxibustion is to promote fetal activity, which may help resolve nuchal cord entanglement during fetal movements.
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.
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.
Will there be changes in the fetal heart rate if the umbilical cord is wrapped around the neck?
When the umbilical cord is wrapped around the neck, there are some situations where changes in the fetal heart rate may occur. The umbilical cord is mostly wrapped around the neck just once, which generally does not affect the growth and development of the fetus, nor does it significantly change the fetal heart rate. The impact on the fetal heart rate in the case of nuchal cord depends on how tight the cord is wrapped around the neck, the number of loops, and the length of the umbilical cord, among other factors. If the umbilical cord is tightly wrapped and has multiple loops, or if it is compressed due to contractions of the uterus, it can obstruct fetal blood circulation and lead to hypoxia in the fetus, thereby affecting the fetal heart rate.
What will the fetal movement be like if the umbilical cord is wrapped around the neck?
Generally, when the umbilical cord is wrapped around the neck, it often does not affect the fetal movement or fetal heart rate changes. It is quite common for the cord to be wrapped around once, and if the wrapping is loose and does not affect the blood supply from the placenta, fetal movement will not change. However, if the cord is tightly wrapped multiple times, it can affect the blood supply of the umbilical cord and impact the fetal blood circulation, leading to frequent fetal movements. Therefore, pregnant women should learn to count fetal movements themselves to understand if the fetus is experiencing hypoxia in the womb.
Does the umbilical cord wrapping always involve the neck?
Umbilical cord entanglement around the neck usually occurs during the mid-pregnancy period, as this is when the baby moves more frequently. The baby has a larger range of movement within the uterine cavity, which can easily lead to the cord wrapping around the neck, abdomen, legs, or arms. Generally, if there is no cord entanglement found after 32 weeks of pregnancy, it is unlikely that it will occur. However, this is not certain. After the baby engages, which is after 35 weeks, the baby's position becomes fixed, and it is unlikely for cord entanglement to occur thereafter.
The difference between a V-type and U-type nuchal cord.
When umbilical cord entanglement occurs, ultrasound examination may reveal a U-shaped or V-shaped entanglement. The V-shape and U-shape both indicate that the umbilical cord is wrapped around the neck once. In such cases, there is no need for excessive anxiety. Sometimes the cord may unwind by itself as the fetal position changes, loosening or alleviating the entanglement. It is important to regularly visit the hospital for prenatal check-ups, rest adequately, enhance nutrition, and adopt a left lateral position to improve placental blood supply.
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.
Does the baby not move much when the umbilical cord is wrapped around the neck and there is not much amniotic fluid for one week?
When umbilical cord wrapping around the neck occurs during pregnancy, it generally does not affect the fetal limb movement. However, a decrease in amniotic fluid can affect the baby's movements. When amniotic fluid decreases, the baby has less room to move inside the uterus, thus causing reduced fetal movements. It is recommended to regularly visit the hospital for prenatal check-ups. If a reduction in amniotic fluid occurs, it is important to promptly identify the reason and then proceed with appropriate treatment. Regular monitoring of fetal movement changes is advised, and fetal heart monitoring can be done to assess the safety of the fetus. Drinking more water to replenish amniotic fluid is also advisable.
The difference between U-shaped and W-shaped nuchal cords.
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.