Can you have a natural birth if the umbilical cord is wrapped around the neck twice?

Written by Liu Wen Li
Obstetrics
Updated on September 25, 2024
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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.

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Written by Du Rui Xia
Obstetrics
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Umbilical cord around the neck ultrasound manifestations

The impact of umbilical cord entanglement on the fetus is quite significant. If the entanglement is excessive and tight, it can lead to fetal hypoxia. Generally, fetuses with the umbilical cord wrapped around the neck once or draped on the neck do not show clinical symptoms. However, if the entanglement is tight, it can jeopardize fetal health. During an ultrasound examination, echoes can be seen on the fetus's neck where the umbilical cord is wrapped, and distinct pressure marks may appear on the skin. A single wrap around the neck appears as a U-shape, two wraps appear as a W-shape, and three wraps as a serrated shape.

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Written by Liu Wen Li
Obstetrics
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How to correct nuchal cord with one loop?

Nuchal cord occurs because the fetus moves frequently within the uterine cavity, which can result in the umbilical cord looping around the neck once, referred to as a single-loop nuchal cord. In fact, it is not correctable because it is impossible to physically reach the umbilical cord or the fetus during pregnancy. Moreover, a single-loop nuchal cord is quite common, occurring in about one-fifth of all pregnancies. If the loop is loose or the umbilical cord is sufficiently long, there is generally no significant impact on the baby. However, if the loop is tight, it can pull on the umbilical cord, causing the blood vessels within the cord to narrow. This may lead to noticeable changes in fetal movements and heart rate. Therefore, with a nuchal cord, it is important to enhance monitoring and pay attention to changes in fetal movements and heart rate.

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Written by Du Rui Xia
Obstetrics
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Does an umbilical cord around the neck always require a cesarean section?

When nuchal cord occurs, it is not always necessary to perform a cesarean section, because sometimes the cord may be loosely wrapped around, even if only for one loop, and in such cases, natural childbirth is still possible. However, if the nuchal cord is wrapped more than two or three times, and is tightly wrapped, and if there is fetal hypoxia inside the uterus, then a cesarean section must be performed to quickly terminate the pregnancy. Nuchal cord is a common cause of difficult labor in pregnant women. Therefore, during the later stages of pregnancy, regular prenatal check-ups should be carried out to monitor the fetus's health. If any abnormalities are detected, it is urgent to admit to the hospital for delivery to avoid potential impacts on the baby, such as hypoxia or asphyxiation.

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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 Zhang Lu
Obstetrics
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Is it dangerous for the umbilical cord to be wrapped around the neck during the mid-stage of pregnancy?

During a mid-pregnancy ultrasound, it is sometimes indicated by the presence of a U-shaped or W-shaped notch behind the fetus's neck that the fetus may have the umbilical cord wrapped around its neck. During pregnancy, it is perfectly normal for the umbilical cord to wrap around the neck, and it generally does not affect the fetus or pose any danger. The length of the umbilical cord during pregnancy is approximately 30 to 80 centimeters, which is quite long relative to the size of the uterine cavity. Hence, many umbilical cords have excess length that can wrap around the neck or limbs of the fetus, leading to the umbilical cord being coiled around the neck or limbs. However, current research indicates that whether the umbilical cord is wrapped around the neck or limbs once or twice, it does not affect the fetus. It does not cause intrauterine hypoxia or affect the growth and development of the fetus, nor does it influence the mode of delivery. A natural childbirth can still be an entirely viable option.