Expectant parents often worry about the umbilical cord wrapping around their baby during pregnancy or labor. While this can happen, particularly around the neck, it is often less hazardous than commonly believed. This article aims to offer clarity and reassurance.
Understanding Nuchal Cords
When the umbilical cord wraps around a baby’s neck, it is referred to as a “nuchal cord.” This can involve a single or multiple loops. The umbilical cord, which supplies oxygen and nutrients from the placenta to the developing fetus, is typically about 21 inches long.
Babies are active within the womb, moving and changing positions frequently. This constant movement is the primary reason why the umbilical cord might wrap around their body, including the neck. In many instances, these wraps are transient; a baby’s continued movement can cause the cord to unwrap itself.
Prevalence and Potential Concerns
Nuchal cords are a common finding, occurring in approximately 20% to 30% of all deliveries. The incidence can increase with advancing gestational age, with reports indicating it may be present in about 6% of pregnancies at 20 weeks and up to 29% at 42 weeks. Most nuchal cords are considered benign and do not cause problems for the baby.
A distinction is made between loosely and tightly wrapped cords. While loose nuchal cords rarely pose issues and can often be slipped over the baby’s head during delivery, a tightly wrapped cord might, in rare cases, lead to temporary compression of the umbilical vessels. This compression could cause a temporary decrease in the baby’s heart rate during contractions due to reduced blood flow and oxygen. Severe complications, such as stillbirth, are rare, and research has found little connection between nuchal cords and such outcomes.
Monitoring and Delivery
Nuchal cords are sometimes detected during routine prenatal ultrasounds, though most often discovered during labor or delivery. During labor, continuous fetal heart rate monitoring is standard practice to assess the baby’s well-being. Variable decelerations in the fetal heart rate, temporary drops, can signal umbilical cord compression, potentially due to a nuchal cord.
If a nuchal cord is present during delivery, medical professionals are prepared to manage the situation. If the cord is loose, it can typically be slipped over the baby’s head once delivered. If too tight to slip over, the doctor or midwife may clamp the cord in two places and cut it before the baby’s shoulders are delivered. This prevents tearing and allows for safe delivery. These routine interventions mean a nuchal cord rarely necessitates an emergency cesarean section, and outcomes are positive for both mother and baby.