Does an umbilical cord around the neck always require a cesarean section?

Written by Du Rui Xia
Obstetrics
Updated on September 12, 2024
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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 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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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.

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Written by Du Rui Xia
Obstetrics
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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.

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Written by Zhang Lu
Obstetrics
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Can you have a vaginal birth if the umbilical cord is wrapped around the neck once?

Umbilical cord wrapping is a common physiological phenomenon during pregnancy, mainly because the length of the umbilical cord during pregnancy generally ranges from 30cm to 80cm, which far exceeds the length needed for fetal growth and development. Therefore, occurrences like the umbilical cord wrapping around the neck or limbs are quite normal. An umbilical cord around the neck is not an indication for cesarean section, and a vaginal delivery is entirely feasible, even if the cord wraps around the neck once or even twice. However, due to the special circumstance of the umbilical cord being wrapped around the neck, it is crucial to pay attention during the delivery process. First, it is important to monitor the fetal heart rate closely, as umbilical cord wrapping can lead to fetal hypoxia, which would be indicated by changes in the fetal heart rate. Second, preparations for an emergency cesarean section should be in place in case of an abnormal fetal heart rate, at which point a cesarean may be necessary to terminate the pregnancy.

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Written by Du Rui Xia
Obstetrics
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Can you exercise with the umbilical cord around the neck?

When a nuchal cord occurs, one should not have too much psychological burden, as it is a fairly common situation. The prognosis should be determined based on the specific circumstances of the nuchal cord, including the number of loops and the tightness of the loops. If the cord wraps around once or if there is a loose knot, appropriate activities can be undertaken. However, if the wrapping is tight, or if there are multiple loops, one should regularly visit the hospital for prenatal check-ups to understand the safety of the fetus in the womb. In such cases, it is necessary to reduce activities to avoid increasing the risk of nuchal cord complications, which could cause fetal hypoxia or even suffocation.