The state and developmental features of the umbilical cord are important both for the process of carrying a baby and for the upcoming birth. The umbilical cord delivers nutrition and oxygen to the baby growing in the mother's womb. Through the vessels of the umbilical cord, the waste products of the child are excreted into the mother's body. What are the dangers of a short umbilical cord, we will tell in this article.
What it is?
The umbilical cord is a temporary organ, like the placenta. It is necessary only during the period of bearing a child. By its structure, the umbilical cord resembles a hollow hose, one end of which is attached to the placenta, the other to the anterior abdominal wall of the baby. Three vessels pass through the umbilical cord - two arteries and one vein. Vienna "supplies" the baby with blood enriched with oxygen and vitamins, and the arteries remove urea, carbon dioxide and other metabolic products of the baby.
Normally, the length of the umbilical cord is 50-70 centimeters. An excessively long umbilical cord creates the danger of repeated entanglement, the occurrence of knots. The umbilical cord is considered to be short if its length is less than 50-40 centimeters. At the same time, an absolutely short umbilical cord stands out, the size of which is initially less than 40 centimeters, and a relatively short umbilical cord, which initially had a completely normal length, but became shorter due to knots, entanglement and for a number of other reasons.
Violation of the length of the umbilical cord is considered a fairly common pathology during pregnancy. The most common form of violation is absolute, in which the dimensions are initially violated. Both types of a short umbilical cord are considered quite dangerous, primarily the likelihood of developing hypoxia in a child. But a relatively short umbilical cord associated with its mechanical entanglement or entanglement has more favorable projections - it can unravel on its own. An absolutely short umbilical cord has no such chance.
Causes of occurrence
Shorter than necessary, the umbilical cord can be hereditary. Often such a pathology is detected in pregnant women who were themselves born with a short umbilical cord. The shortening of the umbilical cord is also often observed in women with pathologies of the placenta, which were formed at the earliest stage of laying a "child's place". These are the main reasons for the development of an absolute short umbilical cord. The rest of the predisposing factors in medicine are not yet obvious.
A relatively short umbilical cord often develops as a result of the umbilical cord entwining any part of the body of the baby. This can happen if the woman is undernourished, is anemic, smokes or drinks alcohol while carrying a baby. Chronic diseases, gynecological problems increase the likelihood of entanglement and shortening of the umbilical cord. Fetal hypoxia, which in its early stages causes an increase in the child's motor activity, also increases the likelihood of entanglement.
Also, the rope is shortened when knots appear on it. Nodes can be true or false. True ones are associated with varicose expansion of one or more sections of the umbilical vessels, and false ones - with mechanical tightening of the nodule as a result of overlap of the cord or loop on it. The share of true nodes accounts for about 2-3% of all cases of shortness of the umbilical cord. Incorrect presentation is also often the reason for the shortening of the cord connecting the child with the placenta.
Symptoms
A short umbilical cord cannot be determined by a woman on her own. This pathology does not present any tangible symptoms, inconveniences for the expectant mother during pregnancy. Most often, the fact of a short umbilical cord is established already during childbirth. This is determined by the increase in the duration of the labor process. In women who give birth for the first time, the duration of labor with a short umbilical cord can increase to 20 hours, and in women who come to the hospital for the second or third time, up to 15 hours.
A short umbilical cord in childbirth is a danger as a factor in the probable abruption of the placenta ahead of time. At the birth of a child, the birth of a child's place within 20-50 minutes is considered normal, but if the short umbilical cord pulls the placenta along with it during the passage of the baby through the birth canal, then early detachment of the “child's seat” may occur, followed by massive bleeding.
Bleeding is dangerous in itself, but no less dangerous is acute hypoxia, which occurs in crumbs if the "child's place" is exfoliated ahead of time. The consequences of such hypoxia can be tragic: the death of a child, irreversible changes in his central nervous system.
During pregnancy, the presence of a short umbilical cord may indirectly indicate a state of chronic fetal hypoxia. However, it cannot be considered a true and indispensable symptom, because hypoxia can be caused not only by a short umbilical cord, but also by a host of other unfavorable factors and pathologies of pregnancy.
It is possible to establish the fact of hypoxia on CTG by the characteristic change in the heart rate of the baby, as well as by the changed nature of the movements. At the initial stage, the baby begins to move more actively, and when oxygen deprivation is of a prolonged nature, the frequency of the child's movements is significantly reduced. This helps it conserve oxygen.
The state of the umbilical cord is studied using ultrasound, and the blood flow velocity in it, the presence of nodes and the relative shortness can be established by undergoing color Doppler ultrasound (USG).
Diagnostics
Diagnosis of a short umbilical cord is a rather troublesome and difficult task, the pathology is difficult to recognize even with good ultrasound diagnostic equipment. If you suspect a short umbilical cord, the doctor must prescribe an ultrasound and ultrasound scan, but it is impossible to guarantee with 100% probability the absence or presence of pathology. One can only make a presumptive diagnosis.
Ultrasound allows you to establish the presence of knots, entanglement, but it is not possible to measure the length of the cord using such an examination. If knots are present, the assumption of a short umbilical cord can be put forward. USDG sets the speed, the intensity of blood flow in the umbilical vessels. In case of a violation of the length, the presence of nodes and entanglement of the fetus, some violations of the blood flow velocity can also be recorded, but the diagnosis of a "short umbilical cord" cannot be made.
Cardiotocography (CTG) makes it possible to assess the baby's heartbeat, to pay attention to the correspondence of his movements to the contractions of the muscles of the uterus. In some cases, with obvious violations of CTG, the doctor may suggest a violation of the length of the umbilical cord, but this, again, does not mean an accurate diagnosis.
Only in isolated cases with a truly short umbilical cord, the pathology is determined by ultrasound (with a very small length of the cord). This allows predicting the course of pregnancy, as well as choosing the right delivery tactics in order to exclude prolonged protracted labor, placental abruption, fetal hypoxia and maternal bleeding.
The state of the umbilical cord is assessed for the first time at the second planned ultrasound, previously this indicator was not considered informative.
Treatment
Despite the fact that every year medicine has new medicines and super-powerful modern equipment in its arsenal, it is impossible to treat a short umbilical cord. If a woman is told about a suspicion of such a pathology, doctors always recommend expectant tactics. If the examination does not show the presence of hypoxia in the baby, the woman can lead a normal life. She is advised to visit her obstetrician-gynecologist more often at the antenatal clinic.
If there is hypoxia or suspicion of it, then the pregnant woman is offered hospitalization in a specialized hospital. Inpatient treatment will also be offered in the case of multiple cord entanglement. How long the treatment will last is rather difficult to say in advance. Some women have to remain under medical supervision until the very birth. The maintenance therapy regimen includes antispasmodics and vitamin preparations, mild sedatives, iron and magnesium preparations, and agents that improve blood flow.
In the presence of fetal hypoxia, as well as in the proven shortness of the umbilical cord, a cesarean section is prescribed in a planned manner. And this is the most favorable option, because surgical intervention eliminates the likelihood of placental abruption before the birth of the baby, as well as the likelihood of other complications in childbirth.
If the umbilical cord of a small length is discovered too late, that is, already during childbirth, the team of obstetricians will dissect the woman's perineum to make it easier for the baby to give birth.
During natural childbirth with a short umbilical cord, doctors constantly monitor the baby's condition using CTG, taking the readings of the device every 30 minutes. If there is the slightest suspicion of hypoxia or other complications, signs of bleeding appear, the woman undergoes an emergency caesarean section.
Effects
A short umbilical cord during pregnancy is not as dangerous as during childbirth. Prolonged labor threatens the occurrence of pelvic injuries, ruptures of the uterus, cervix, vagina. For a baby, a long and painful birth is also not the best option for the development of events, because he may begin to experience acute oxygen starvation.
Often, children born with a short umbilical cord in a natural way with all the accompanying complications lag behind in physical and mental development, they have problems with the development of speech, memory, it is more difficult for them to learn. CNS disorders that develop due to acute traumatic hypoxia (for example, when the umbilical cord is torn off due to tension during childbirth or when placenta abruption) can have disabling consequences.
After childbirth, there are no peculiarities in ligating the baby's umbilical cord. The cord is cut off in a completely traditional way, the umbilical wound heals similarly to the wounds of other babies born with an umbilical cord of normal length. A short umbilical cord, contrary to popular belief, does not increase the likelihood of an umbilical hernia in a baby.
Prevention
There is no prevention of the shortness of the umbilical cord, since a woman practically cannot influence its length by any action. But doctors recommend not to lose sight of the main and most common cause of the development of the anomaly - the hyperactivity of the fetus itself. In this regard, women who have just learned about their "interesting" position are recommended to eliminate coffee, chocolate, cocoa from the diet as soon as possible - such products "invigorate" not only the mother, but also the baby.
To exclude the entanglement and shortening of the umbilical cord, a woman should breathe more fresh air, lead a moderately active lifestyle, visit her doctor, without missing a single scheduled visit. A baby who receives enough oxygen and nutrients is much less likely to be entwined with an umbilical cord.
That is why it is important to give up bad habits, not to take any medications without the permission and approval of a doctor, not to come into contact with varnishes and paints, toxins and chemicals. It's important to stop being nervous. Whatever happens in the life of a pregnant woman, she must always remember that experiences are temporary, and the health of the unborn child is almost constant, and a lot depends on the calmness of the mother during the gestation of the fetus.
If a woman herself was born with a short umbilical cord, she should definitely talk to a geneticist at the stage of pregnancy planning. If the pathology has already been detected, you should not panic - modern medicine has a sufficient arsenal to save the lives of mothers and babies without harming their health.
A pregnant woman needs to pull herself together and trust the doctor - if he recommends a cesarean section, then he has good reason for that, and you should not resist it.
For information on the causes and consequences of a short umbilical cord, see the next video.
