What should I do if the umbilical cord is wrapped around the neck?

Written by Liu Wen Li

Obstetrics

Updated on September 16, 2024

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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 Du Rui Xia

Obstetrics

46sec

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Can ultrasound detect nuchal cord?

During the color ultrasound examination, it is possible to detect whether the fetus is experiencing umbilical cord entanglement around the neck. If the ultrasound shows a V-shaped echo around the fetal neck, it generally indicates that the umbilical cord is wrapped around once. If the echo is W-shaped, then the cord is wrapped twice. If the cord is wrapped multiple times, the echo will appear serrated. Additionally, the color ultrasound can also assess the blood flow around the umbilicus to determine the presence of umbilical cord entanglement. If cord entanglement is detected, it is recommended to have regular ultrasound check-ups at the hospital to monitor the fetus's safety in the uterus.

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Written by Du Rui Xia

Obstetrics

30sec

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Why doesn't the ultrasound show the umbilical cord around the neck?

Generally, in cases where there is umbilical cord entanglement around the neck, it can be detected through an ultrasound examination. However, if the ultrasound does not show the umbilical cord wrapped around the neck, it is possible that the cord moved back around as the fetus moved during pregnancy. It might also be that the cord is not fully wrapped around the fetus's neck, but rather draped over the shoulder or neck. This situation could also relate to the fetal position, making it undetectable.

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Written by Du Rui Xia

Obstetrics

53sec

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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 Zhao Su Min

Obstetrics

1min 4sec

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How to correct the umbilical cord wrapped around the neck once?

The umbilical cord is wrapped around the neck once, and there is no way to correct it; it cannot be rectified by changing position or through medication. The umbilical cord being wrapped around the neck once can be due to the umbilical cord being relatively long, or the fetus having a large range of movement within the womb. During pregnancy, as the fetal movements change, it might wrap around twice or even three times, although it's also possible that there will be no wrapping of the umbilical cord around the neck by the end. There is no need to panic if the umbilical cord is wrapped around the neck once. Pay attention to fetal movements and attend regular prenatal check-ups. If there is an increase or decrease in fetal movements, it is important to visit the hospital promptly to have an ultrasound, listen to the fetal heartbeat, and check for any signs of fetal hypoxia. If fetal hypoxia is present, oxygen therapy should be administered, and pregnancy termination may be necessary if required.

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Written by Zhang Lu

Obstetrics

1min 6sec

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Can placenta previa with the umbilical cord wrapped around the neck one time be delivered vaginally?

Placenta previa and umbilical cord around the neck are two relatively common clinical conditions during pregnancy, and they have different impacts on natural childbirth. First, having the umbilical cord wrapped around the neck once is a very normal physiological occurrence, and it generally does not affect the ability to have a natural childbirth in any situation. Therefore, from the perspective of the umbilical cord around the neck, it does not affect natural childbirth. Second, placenta previa refers to the lower edge of the placenta being close to the internal os of the cervix. Whether natural childbirth is possible mainly depends on the type of placenta previa. If it is a partial or central placenta previa, such conditions generally cannot proceed with natural childbirth, as they might cause significant bleeding, necessitating an elective cesarean section. However, in the case of marginal placenta previa, where there is still some distance between the lower edge of the placenta and the cervical os, attempting natural childbirth might be possible, provided that preparations for a cesarean section are in place.