Is it dangerous to entangle the umbilical cord around the neck of the fetus and how does it affect childbirth?

During pregnancy, the baby has a special bond with his mother. At the biological level, this connection is made through the umbilical cord. This article describes in detail whether it is dangerous to entangle the umbilical cord around the neck of the fetus, how it affects childbirth.

What it is?

The umbilical cord is a very important organ that is formed in the body only in a pregnant woman. In appearance, the umbilical cord resembles a twisted gray-blue cord. The length of the umbilical cord varies. In some cases, it can be quite long, which can contribute to the formation of various pathologies during pregnancy.

One of these pathological conditions is the entanglement of the umbilical cord around the neck of the fetus. In this case, the umbilical cord loops are located directly on the baby's neck.

Umbilical cord entanglement is a diagnosis that can scare every pregnant woman. Many women remember that when doctors diagnosed them during pregnancy, they experienced a real fear for the life of their baby. You can understand this reaction.

The umbilical cord entanglement around the fetal neck is a rather dangerous pathology that requires careful medical supervision, as well as the search for suitable tactics for managing pregnancy, and in the future - and the correct way of obstetric aid.

Causes of occurrence

The development of the umbilical cord entanglement of the fetal neck occurs for various reasons. Doctors identify several reasons that can lead to the development of this pathology during pregnancy:

Genetics. The looping of the umbilical cord around the baby's neck may be due to genetic factors. Some scientists believe that the length of the umbilical cord is a hereditary factor. The average length of the umbilical cord is approximately 40-60 cm. In some cases, it is lengthened (up to 75-80 cm and more). In such a situation, the risk of entanglement formation is quite high.
Stress and traumatic influences. Scientists have revealed an interesting fact: pregnant women, who are often nervous and worried for various reasons during pregnancy, have a rather high risk of developing this pathology. They believe that the cause is an increase in the level of certain hormones during stress, one of which is adrenaline.

Changes in the amount of hormones in the blood can enhance the motor activity of the fetus, as well as lead to certain functional disorders. In some cases, this contributes to the fact that the umbilical cord is entwined around the baby's neck.

Change in the amount of amniotic fluid. For the existence and full-fledged intrauterine development, the child needs an aquatic environment. If there is enough amniotic fluid, the baby feels good. At the same time, nothing interferes with his motor activity. If, for some reason, the amniotic fluid in the uterus becomes larger, this can contribute to the formation of a number of pathologies. One of them is twisting the umbilical cord loops around the baby's neck.

Environmental factors. Some scientists believe that climatic conditions can also cause the umbilical cord to wrap around the baby's neck during intrauterine development. The researchers note that a sharp change in climate can lead to the formation of this pathology during pregnancy. A change in climatic conditions during pregnancy most often contributes to the development of this pathology in women who suffer from any chronic diseases. During pregnancy, moving to another city, where climatic conditions differ significantly, the body of the expectant mother perceives as severe stress. In such a situation, the risk of the umbilical cord entwining the fetus's neck is also significantly increased.

It is believed that overheating and hypothermia of a pregnant woman's body are factors that can contribute to this.

Smoking... Some doctors note that umbilical cord entanglement occurs more often in women who smoke. This can be facilitated by the entry into the bloodstream of nicotine and other chemicals that are found in large quantities in cigarettes. They have an adverse effect on the intrauterine development of the baby, contribute to the occurrence of various diseases.
Alcohol... Another bad habit that can lead to an umbilical cord entanglement is the use of alcoholic beverages. The ethyl alcohol they contain has a negative effect on the blood vessels in the umbilical cord. Such an effect leads to the occurrence of various disorders in the fetus, including it is a possible factor in the development of the twisting of the umbilical cord around the baby's neck.

Intense sports... Obstetricians-gynecologists note that active physical exercises can also lead to entanglement. Expectant mothers who had a long umbilical cord and some other features during pregnancy should be extremely careful while playing sports. The possibility of visiting the gym or swimming pool in such a situation should be discussed with your doctor. In some cases, the umbilical cord entwining the baby's neck can be a contraindication for sports and fitness.

Doctors recommend that expectant mothers, who have entanglement, spend more time in the fresh air. At the same time, it is better to walk at a moderate pace. Special breathing exercises will also help improve your overall well-being. They can be performed throughout the entire period of pregnancy.

How could it be?

Umbilical cord loops can be wrapped around the fetus's neck in different ways. Doctors identify several clinical variants of this pathology. It all depends on how many times the umbilical cord loops are wrapped around the baby's neck. Doctors distinguish one-, two- and three-fold entanglement.

If, for some reason, the umbilical cord is wrapped in its loops more than three times, then such an entanglement can be considered multiple. Each of the clinical variants has its own specific developmental characteristics.

One-time

With this variant of the pathology, the umbilical cord loop is wrapped around the child's neck only once. This variant of the pathology occurs in 20-25% of pregnant women. Usually, expectant mothers are faced with an uncomfortable entanglement. This means that the umbilical cord loop does not tightly surround the fetal neck and does not squeeze it. The prognosis of the further development of pregnancy with this variant of the pathology is most favorable.

A tight single entanglement is considered less favorable. In this case, the umbilical cord loop around the neck can compress the cervical spine. In such a situation, the child may experience very dangerous complications.

Double

With this variant of the pathology, the umbilical cord loops are wrapped around the neck of the fetus 2 times. Doctors can determine this pathology at different stages of pregnancy. If detected early, the prognosis is usually quite good. If there is a sufficient amount of amniotic fluid in the uterus, and the fetal motor activity is not disturbed, it can still "unravel" before the onset of labor.

If doctors determine that the umbilical cord is twisted twice around the fetus's neck after 37-38 weeks of pregnancy, as a rule, this condition remains until the very birth. By this time, the baby is already quite large and moves much less. This is due to the fact that every day, as the birth approaches, it becomes more and more "cramped" in the uterus.

Triple

This option is relatively rare in obstetric practice. Three times entanglement with the umbilical cord can also lead to the development of a number of complications (or be relatively normal).

A favorable prognosis for the development of this pathology can be in the event that the loops of the umbilical cord do not squeeze each other very strongly. If they tightly squeeze each other, then in such a situation, the child may develop intrauterine hypoxia. In this case, urgent medical intervention is required and the choice of the correct tactics for the further management of pregnancy.

How to suspect?

Unfortunately, there are no direct clinical signs that would indicate the presence of this pathology during pregnancy. It is possible to suspect the presence of an entanglement of the umbilical cord with the fetus's neck only if certain complications of the pregnancy are already beginning to appear. In most cases, this pathology is detected by chance - during a routine ultrasound examination.

If the expectant mother is diagnosed with an umbilical cord entanglement around the fetus's neck, then she should be quite attentive to her general condition, as well as the well-being of her baby. One of the signs that may indicate that the baby is experiencing discomfort in the mother's womb is a change in his motor activity. This is especially true in the fetus after 28-31 weeks of gestation. By this time, the baby has already formed a circadian (daily) rhythm. This contributes to the fact that the child, as a rule, is more active during the daytime, and usually rests at night.

If the expectant mother began to notice that her baby began to move much less or is too “active” at night, then she should definitely show herself to her obstetrician-gynecologist.

The doctor will conduct the necessary examination, thanks to which it will be clear how the baby is feeling, whether any complications of the pregnancy have developed.

Diagnostics

The basic diagnostic method that allows you to identify this pathology is ultrasound. Before the advent of ultrasound techniques, doctors could not determine entanglement. This often contributed to the fact that a pregnant woman with this pathology experienced certain complications during natural childbirth. Currently, ultrasound specialists can quite successfully detect signs of the umbilical cord entanglement of the fetal neck.

Ultrasound examination is the basic, but not the only study that is carried out when establishing the diagnosis of entanglement. To assess the condition of the fetus, doctors must also resort to other diagnostic tests. One of them is a Doppler study.

By conducting it, you can assess the blood flow through the vessels that are in the umbilical cord. This allows doctors to exclude dangerous complications of the course of pregnancy, including identifying intrauterine hypoxia. To assess the dynamics of the well-being of the baby in the mother's womb, doctors can perform Doppler sonography several times. This allows them to track any possible pathologies and complications that may arise before delivery.

Another diagnostic method that allows you to assess the general condition of the fetus is cardiotocography. This simple and painless method allows doctors to determine the functioning of the child's heart, as well as his physical activity. If everything is normal, no significant changes in these indicators occur. If the baby develops intrauterine hypoxia, this can be indirectly determined on the cardiotocogram.

The undoubted advantage of this method is the possibility of its repeated implementation. An expectant mother who has been diagnosed with an umbilical cord entanglement may be prescribed cardiotocography several times before the onset of labor. Such dynamic observation allows doctors to timely identify dangerous complications and, if necessary, change the tactics of pregnancy management.

Consequences for the fetus

To understand what the danger of the development of various complications in this pathology lies in, one should touch on some biological features a little. It is important to remember that the fetus receives oxygen during intrauterine life not through the trachea and its own respiratory tract, but in a dissolved form through the blood. Oxygen in this situation enters the child's body through the system of blood arteries, which are located in the umbilical cord.

So it becomes clear that the main condition for the normal intrauterine development of the baby and the full supply of oxygen is the location of the loops around the neck with two and multiple entanglements.

If the loops are tightly squeezed, this can lead to strong compression of the blood vessels located in the umbilical cord. In such a situation, the fetus does not receive a sufficient amount of dissolved oxygen, which can contribute to the development of intrauterine hypoxia - oxygen deficiency of all internal organs and tissues.

Prolonged intrauterine hypoxia is an extremely dangerous condition. It contributes to the fact that the child's functioning of all internal organs is disturbed, including the vital ones - the heart and the brain. In such a situation, the fetus may develop certain pathologies (and even developmental anomalies).

Intrauterine hypoxia can lead to early onset of labor. In such a situation, the baby can be born much earlier than the due date. In this case, the baby may be premature, and his lungs will not be ready for spontaneous breathing.

Strong compression of the blood vessels that are inside the umbilical cord can also lead to a violation of the blood supply to the placenta. In such a situation, the functioning of the placenta is disrupted. In some cases, this can even lead to the development of detachment of placental tissue from the uterine wall. This pathology can be extremely dangerous and cause the development of premature birth.

Natural independent childbirth, complicated by the presence of a tight multiple entanglement with the umbilical cord of the fetus's neck, can be dangerous and the occurrence of dangerous injuries and injuries. As a rule, in this case, the child has various injuries of the cervical spine. The severity of these injuries varies. To prevent this, doctors still try to resort to performing a caesarean section.

Remember that every pregnancy is unique. Doctors can only predict the development of certain complications. The birth of a healthy baby with an elongated umbilical cord depends on many factors. In one case, a healthy baby is born, and in the other, a child who has some pathologies during childbirth.

Features of labor management

The choice of obstetric tactics largely depends on how tightly the cord is wrapped around the baby's neck. With a single entanglement, doctors can also allow natural childbirth. In this case, during labor, the obstetrician-gynecologist must monitor the appearance of the head. As soon as she is born, the doctor can independently remove the umbilical cord loop from the neck. In this case, the natural process of childbirth, as a rule, is not disturbed.

When detecting a double entanglement of the umbilical cord with the fetus's neck a few weeks before pregnancy, doctors usually choose a surgical method of obstetrics. In such a situation, natural childbirth can be very dangerous. During labor, the umbilical cord loops can severely squeeze the baby's neck, which will lead to the development of dangerous complications (and even, possibly, birth injuries).

When the umbilical cord is entwined three times around the fetus's neck, doctors often resort to performing a caesarean section.The surgical method of obstetrics is also used in cases where there are other features of the course of pregnancy.