What to do if the umbilical cord is wrapped around the neck once in late pregnancy?

Written by Zhang Lu
Obstetrics
Updated on September 15, 2024
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During the late stages of pregnancy, a B-ultrasound might sometimes reveal that the fetus has the umbilical cord wrapped around its neck once. This condition is a physiological occurrence. Having the cord wrapped once around the neck does not cause intrauterine hypoxia or harm the growth and development of the fetus inside the womb. The vast majority of cases where the cord is wrapped are physiological, and whether the cord is wrapped around once or twice, there is no need for excessive worry. In the late stages of pregnancy, the most important thing when the cord is found wrapped around the neck is to monitor fetal movements. As long as the fetal movements are good, it indicates that the fetus is in a normal condition inside the womb. It is also important to keep up with regular prenatal check-ups to assess whether the fetal growth and development are normal. Additionally, it is not advised to take any action to intervene when the cord is wrapped around the neck, as neither adopting sleeping positions nor any other methods can release the cord from the neck. These methods are futile and sometimes might even harm the fetus.

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Written by Liu Wen Li
Obstetrics
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Is there any danger in natural childbirth with the umbilical cord wrapped around the neck once?

Umbilical cord wrapping around the neck once is completely manageable with a natural birth, as it is very common in clinical practice, and many pregnant women with the umbilical cord wrapped around the neck have successfully delivered naturally. Even cases where the umbilical cord wraps around the neck twice, or even three times, can still undergo natural childbirth. Therefore, trying for a natural birth with the umbilical cord wrapped around the neck once is entirely feasible. Of course, during this process, it is necessary to monitor changes in the fetal heart rate or other conditions. As long as there are no issues with the fetal heart or other aspects, the mere fact of the umbilical cord being wrapped around the neck does not affect the delivery.

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Written by Du Rui Xia
Obstetrics
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Can umbilical cord around the neck perform fetal position correction?

In cases of nuchal cord, it is not advisable to attempt correcting abnormal fetal positions, because if the fetal position changes abnormally after an attempted correction while the umbilical cord is wrapped around the neck, it may worsen the degree of the nuchal cord, potentially leading to fetal hypoxia or even asphyxiation. However, if the umbilical cord is relatively long, it might not affect the changes in fetal position, and sometimes the fetus can automatically free itself from the nuchal cord through its own movements. It is important to regularly visit the hospital for prenatal check-ups to detect any other potential abnormalities.

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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 Du Rui Xia
Obstetrics
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Can the umbilical cord unwrap itself after it has wrapped around the neck and entered the pelvis?

When the fetus has already engaged and there is nuchal cord occurrence, it is generally unlikely for the wrapping to unwind again. This is because once the fetus has engaged, the fetal position is fixed, and the fetus will no longer change its position, making the nuchal cord a more fixed condition. When dealing with nuchal cord, it is important to observe the number of loops and whether the tightness of the loops could impact the fetus. Therefore, it is necessary to regularly attend prenatal appointments at the hospital to monitor its developmental condition. If the nuchal cord loops just once around the neck, it usually does not affect the baby.

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Written by Liu Wen Li
Obstetrics
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Can you have a natural birth if the umbilical cord is wrapped around the neck twice?

The umbilical cord wrapped around the neck twice is something that can definitely be attempted, meaning a trial of natural delivery, or vaginal trial. Clinically, there have been many cases where the umbilical cord was wrapped around the neck twice, and the baby was delivered smoothly. Therefore, it's unnecessary to avoid a trial of delivery and opt for cesarean section just because the umbilical cord is wrapped around twice; that would be somewhat excessive. Of course, when the cord is wrapped around the neck twice, since the wrap is relatively tight, the remaining length of the cord might be short, and when the baby's head moves downward, there could be changes in the fetal heart rate, but not necessarily in all cases. Therefore, for pregnant women with the umbilical cord wrapped around the neck twice, doctors will closely monitor changes in the fetal heart rate during the delivery process.