How to prevent umbilical cord entanglement in late pregnancy

Written by Zhang Yin Xing
Obstetrics
Updated on January 08, 2025
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There are no effective prevention methods for nuchal cord, which is the most common form of umbilical cord entanglement where the cord wraps around the fetus's neck, limbs, or trunk. Nuchal cord occurs in 90% of these cases, frequently involving the cord wrapping around the neck once. This phenomenon can be observed in 20% of deliveries and is associated with factors such as an overly long umbilical cord, a small fetus, excessive amniotic fluid, and frequent fetal movements. An excessively long umbilical cord is mostly a physiological occurrence since the cord floats in the amniotic fluid and its actual length cannot be accurately measured, with no effective methods to prevent its occurrence. Excessive amniotic fluid and a small fetus are linked to certain pregnancy complications, such as diabetes-induced polyhydramnios and restricted fetal growth. Actively controlling blood sugar during pregnancy can prevent such issues. Frequent fetal movements are physiological for some pregnant women. Women who experience more frequent fetal movements throughout pregnancy are likely to encounter nuchal cord. Clinically, nuchal cord does not require special management unless it leads to obstructions in fetal descent, fetal distress, or variations in fetal heart rate. It does not impact delivery or fetal development.

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Written by Liu Wen Li
Obstetrics
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Is there any danger in natural childbirth with the umbilical cord wrapped around the neck once?

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 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 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
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Does umbilical cord around the neck require a B-ultrasound recheck?

When there is a situation of umbilical cord around the neck, pregnant women need to regularly visit the hospital for an ultrasound checkup to understand the condition of the umbilical cord entanglement, mainly to monitor the umbilical blood flow. If there is an increase in umbilical blood flow, it indicates that the cord entanglement is tight, which can affect the baby's safety, potentially leading to lack of oxygen or suffocation. Therefore, in the late stages of pregnancy, it is also necessary to go to the hospital every 3-7 days for fetal heart monitoring to check if there is any lack of oxygen in the fetus while inside the womb. If there is fetal hypoxia in the late stages of pregnancy, it is advisable to terminate the pregnancy in a timely manner.

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Written by Du Rui Xia
Obstetrics
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Can nuchal cord be corrected by lying prone?

Nuchal cord refers to a condition during pregnancy where the umbilical cord wraps around the fetus's neck or abdomen due to the baby's continuous movements and changes in position. Lying prone cannot correct a nuchal cord because the fetus can move freely within the womb. In some cases, the baby may even resolve the issue through its movements, so there is no need for excessive worry. It is only necessary to visit the hospital regularly for prenatal check-ups, follow the doctor's advice, and monitor the fetal heart rate. Generally, this does not cause any adverse effects.