Is there any danger in natural childbirth with the umbilical cord wrapped around the neck once?

Written by Liu Wen Li
Obstetrics
Updated on September 18, 2024
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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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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.

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Written by Zhang Yin Xing
Obstetrics
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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.

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Written by Du Rui Xia
Obstetrics
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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.

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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?

Umbilical cord entanglement around the neck is a common complication for pregnant women. It mostly occurs with the umbilical cord wrapped around the neck once, accounting for about 20% of all deliveries, which means that 1 in 5 pregnant women will experience this condition. The main danger of umbilical cord entanglement is that if the cord is wrapped tightly or is short, it can pull on the cord during pregnancy or delivery, causing the blood vessels within the cord to constrict. This constriction can decrease the fetal blood circulation, leading to fetal distress, which is characterized by changes in fetal heart rate and fetal movement. Therefore, if there is umbilical cord entanglement, it is important to enhance monitoring during pregnancy and delivery. If fetal distress or fetal hypoxia occurs, a cesarean section should be performed promptly to terminate the pregnancy.

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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.