Double cord entanglement is a fairly common complication of pregnancy. Its essence lies in the fact that the umbilical cord twice braids any part of the fetus's body. Modern clinical technologies make it possible to carry out childbirth with this pathology in most cases without consequences for the mother or fetus. Depending on the type of entanglement and possible threats to the fetus, the method of delivery is selected.
What are the risks for a child whose intrauterine development proceeds with a double entanglement? Can such a defect be prevented?
Causes
An umbilical cord entanglement can occur if the following factors are present:
- Fetal hypoxia. If the fetus is regularly deficient in oxygen for one reason or another, then his body can react to this with increased motor activity, which is why the baby can get entangled in the loops of its own umbilical cord and its further intrauterine development will proceed in this position.
- Increased concentration of adrenaline in the mother's blood. This factor also affects the frequency of active fetal movements.
- Too long umbilical cord (more than 0.6 m).
- Polyhydramnios. Too much free space around the baby often causes the appearance of repeated entanglement with the umbilical cord.
Usually, a double entanglement with the umbilical cord is diagnosed up to 28-32 weeks, since after this period the fetus becomes large enough, which prevents its active movement in the womb.
Complications
The main danger posed by compression of the baby's neck with the umbilical cord is hypoxia. Also, such a complication of pregnancy can lead to injuries during childbirth. Children with double entanglement may further suffer from recurrent migraine attacks, hypertension (persistent increase in blood pressure) or hypotension (persistent decrease in blood pressure), as well as reduced working capacity.
Persistent fetal hypoxia can cause the death of the baby or lead to the development of severe neurological disorders due to the death of brain cells. This happens quite rarely, and in such situations, doctors generally prescribe delivery by caesarean section.
The consequences for the body from oxygen starvation are not always manifested by obvious structural or physiological defects. In addition, the severity of the resulting brain damage during hypoxia in different children may differ: for some, double entanglement with the umbilical cord is just an entry in the medical record, but for others it is the reason for constantly sitting at the doctors' offices.
However, one should not think that if during childbirth the child experienced hypoxia and received damage in the form of any violations, then such a baby is guaranteed disability. With all medical recommendations, careful care and attention, such a child has every chance to grow up healthy and be no different from his peers.
Diagnostics
It is possible to identify the presence of double entanglement with the umbilical cord using cardiotocography. The essence of this diagnostic study is to continuously record the fetal heart rate and the degree of uterine tone. According to the indicators taken from CTG, a specialist can determine whether there is oxygen starvation of the fetus.
To confirm the diagnosis, an ultrasound scan is performed, thanks to which you can visualize the fetus and identify the entanglement of the umbilical cord. Thanks to the data obtained, the doctor will be able to accurately name the number of loops entwining the baby's body, and assess the nature of the entanglement - very tight, strong or not.
Prevention
As a preventive measure, to avoid the occurrence of entanglement of the fetus, the expectant mother should follow a number of recommendations:
- normalize (as far as possible) your emotional background;
- walk more often and be in stuffy, unventilated rooms as rarely as possible;
- observe the basic principles of good nutrition;
- visit a doctor in a timely manner, pass all the examinations assigned to him on time;
- systematically engage in gymnastics for pregnant women, having previously agreed on a list of exercises with your obstetrician.
Often, with repeated entanglement and tight compression of the baby's neck with the umbilical cord, the expectant mother is placed under observation in a hospital.
If the situation becomes threatening, the obstetrician supervising the pregnancy may recommend prompt delivery ahead of the due date.
Obstetric care
In world clinical practice, in most cases, natural childbirth with entanglement ends successfully. If in this case neither the fetus nor the mother has concomitant pathologies, then they are discharged from the hospital in a few days on a general basis. However, childbirth in a woman who has been diagnosed with fetal entanglement should proceed with increased medical supervision, which includes monitoring the fetal heart rate in the first and second stages of labor. For this, the methods of instrumental diagnostics are used: ultrasound, Doppler ultrasound and cardiotocography.
When the baby's head is born, the doctor removes the umbilical cord loops from his neck and the birth continues as usual. Only with tight or multiple entanglement is the question of operative delivery raised. In some situations, this may be the only way to avoid birth complications.
Superstition
Despite the advancing progress by leaps and bounds, in our society, judging by the numerous reviews, superstitions associated with various signs are still quite popular. During pregnancy, even the most sane woman tends to give in to prejudice. This is largely due to fear for the health of the unborn baby. Therefore, pregnant women often do not dare to do needlework, explaining this by the fact that such actions supposedly can provoke the appearance of umbilical cord loops in the future baby's neck.
This is due to the fact that in the old days women were engaged in knitting and sewing in poorly lit huts, which were heated by a wood-burning stove, which is why the air in the house was quite stuffy. Because of this, the fetus for a considerable time was in a state that was not very useful for a woman, because the mother sat for a long time in a motionless position, slouched over. As a result, the baby experienced a lack of oxygen and, as a result, began to actively move, which often became the reason for throwing the umbilical cord loops around the neck. Noticing such a pattern, the people made up signs with which in our time they continue to intimidate some overly impressionable pregnant women.
Today, most women have the opportunity to provide themselves with comfortable conditions for needlework. Therefore, you should not deny yourself the pleasure of spending time doing what you love because of superstition.
There is also a belief that the umbilical cord entanglement is formed when the arms are raised frequently. In fact, there is nothing dangerous in raising hands, just in the old days women of the peasant class did hard work, raising their hands, for example, hanging wet clothes. Actions of this nature could provoke excessive activity of the fetus, which, in turn, could cause entanglement.
Our contemporaries have the ability to limit physical activity to acceptable limits, so if a woman in a "position" raises her hand to get a book from the shelf, her child will not be harmed by this, especially in the early weeks of gestation.
If hand lifts are performed as part of health-improving gymnastics, then such movements will benefit both the expectant mother and the baby.
In our time, when perinatal diagnostics has reached unprecedented heights, cord entanglement is not an extremely threatening condition for the fetus. It is possible to avoid the development of serious pathologies due to hypoxia, provided that a specialist is visited in a timely manner and all his appointments are accurately fulfilled. It is also important to actively engage in the prevention of the development of such a complication.
For more information on double cord entanglement, see the next video.
