What will the fetal movement be like if the umbilical cord is wrapped around the neck?

Written by Du Rui Xia
Obstetrics
Updated on January 27, 2025
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Generally, when the umbilical cord is wrapped around the neck, it often does not affect the fetal movement or fetal heart rate changes. It is quite common for the cord to be wrapped around once, and if the wrapping is loose and does not affect the blood supply from the placenta, fetal movement will not change. However, if the cord is tightly wrapped multiple times, it can affect the blood supply of the umbilical cord and impact the fetal blood circulation, leading to frequent fetal movements. Therefore, pregnant women should learn to count fetal movements themselves to understand if the fetus is experiencing hypoxia in the womb.

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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 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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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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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 Du Rui Xia
Obstetrics
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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.