Among the various pathologies associated with the presence of umbilical cord defects, there are quite dangerous ones. A true umbilical cord knot is one such insidious pathology. This article will tell you about what a true umbilical cord knot is, how it is dangerous for a child.
What does this mean?
Normally, the umbilical cord or umbilical cord is an elongated "cord". It stretches from the baby to the placenta. The umbilical cord can be considered a kind of "bridge", which during pregnancy connects an actively developing baby with his mother.
The umbilical cord is quite long. In normal pregnancy, the length of a healthy umbilical cord is 50-70 cm. The thickness of the umbilical cord is usually about 2 cm. Such a rather long length contributes to the fact that the umbilical cord can twist into loops or even knots. Doctors call such nodules true.
It should be noted that this pathology is quite rare in obstetric practice. If you focus on statistics, it can be noted that true nodes on the umbilical cord appear in about 1% of all cases. However, this pathological condition is extremely dangerous. It can significantly aggravate the course of pregnancy and even contribute to the development of dangerous pathologies in the fetus.
Reasons for education
Various factors can lead to the appearance of nodules on the umbilical cord. The most common reason for the development of this pathology is the intense physical activity of the baby. Usually, the fetus that develops in the womb is more mobile in the first half of pregnancy. The smaller the size of the child, the easier it is for him to move.
As the baby grows, the number of active movements he performs begins to gradually decrease. This happens because the baby gradually becomes cramped in the uterus. This feature determines the fact that true nodules on the umbilical cord are formed mainly before the 3rd trimester of pregnancy. This fact is confirmed by the reviews of mothers who encountered this problem while carrying babies.
Diagnostics
It should be noted right away that determining the true nodules on the umbilical cord is a rather difficult task. Usually, such changes are detected by doctors already retrospectively - after the birth of a child. After the birth of the placenta and umbilical cord, doctors can carefully examine them. With this examination, as a rule, true nodules are revealed.
Unfortunately, it is impossible to suspect the presence of pathology only by some clinical signs or symptoms. There are no specific signs that would absolutely definitely indicate the presence of nodules on the umbilical cord.
It is worth noting that sometimes nodules on the umbilical cord are still found during ultrasound. This usually becomes possible when the research is carried out on an expert-level apparatus by an experienced and qualified specialist. The difficulty in finding true nodules on the umbilical cord is that the umbilical cord is quite long. An ultrasound specialist cannot always examine every centimeter of it.
Doppler ultrasound can be used to suspect the presence of a node on the umbilical cord. This method allows you to assess the blood flow in the umbilical vessels. A decrease in the rate of blood flow in certain parts of the umbilical cord is one of the signs that may indicate the presence of a node.
If, during pregnancy, the expectant mother with an ultrasound scan found nodes on the umbilical cord, then in the future, she is under close medical supervision. In the time remaining before delivery, doctors must assess the condition of the fetus. For this, cardiotocography is often used. With this diagnostic test, you can determine the heart rate of the baby, as well as assess his motor activity.
The expectant mother herself can also control the activity of the baby. In the second half of pregnancy, she, as a rule, already quite well feels the baby in her stomach.
If a pregnant woman notes that her child has dramatically changed his motor activity, then she should definitely warn her obstetrician-gynecologist about this.
Consequences for the child
It is impossible to imagine the full development of a baby without an umbilical cord. With the help of this unique organ, which appears in the female body only during pregnancy, the fetus receives all the nutrients necessary for its growth. A baby in a mother's womb cannot feed on its own. He receives all the necessary proteins, fats and carbohydrates through the blood from his mother. In this case, nutrients enter through the blood vessels, which are located directly inside the umbilical cord.
Through the umbilical cord vessels, the baby receives oxygen dissolved in the blood. During intrauterine life, the baby's lungs do not function. The respiratory system will work fully only after the baby is born and takes his first breath in his life. Up to this point, the baby receives dissolved oxygen through the umbilical cord vascular system - from his mother.
The umbilical cord plays another important role: it is involved in the utilization of metabolites. Through the system of umbilical cord vessels, the fetus "gets rid" of waste chemicals unnecessary to its body. Ensuring the functions of the umbilical cord is possible if during pregnancy no abnormalities or defects develop in the umbilical cord. The presence of nodes contributes to the fact that the blood vessels located in the umbilical cord are pinched. In this case, the blood supply to the baby and the placenta is disrupted.
Insufficient oxygen supply to the blood contributes to the fact that the baby develops an extremely dangerous condition - intrauterine hypoxia. It is dangerous because the blood supply to the child's internal organs is greatly reduced. This leads to disruption of their functioning.
Persistent intrauterine hypoxia is also dangerous because the baby may develop a violation of cardiac activity. This situation is extremely dangerous and requires urgent medical intervention to save the life of the fetus.
In some cases, it is possible to determine the consequences of prolonged intrauterine hypoxia in a baby only after his birth. Children who, during their intrauterine development, have encountered this pathology, may have less birth weight, low immunity, as well as a number of concomitant congenital diseases. In some cases, persistent intrauterine hypoxia can contribute to the formation of a number of pathologies of the nervous system.
Another possible complication that can develop in the presence of true nodes on the umbilical cord is thrombosis of the umbilical cord. In the clamped area of the umbilical cord, blood flow is significantly reduced. The slowing down of blood flow causes the platelets (platelets) to stick together more quickly, leading to the formation of blood clots.
Full blood flow is impossible through the thrombosed umbilical cord. In such a situation, the child's body does not receive enough nutrients and oxygen. The more closed the lumen of the blood vessels of the umbilical cord, the more unfavorable the prognosis for the further course of pregnancy. Unfortunately, in such a situation, there is a high risk of termination of pregnancy (and even stillbirth).
Forecasts
It is important to note that having true knots is not always a sentence. The prognosis of the course of pregnancy depends on many factors. Umbilical cord nodules can appear at a variety of times during pregnancy. If they appeared early, then the expectant mother should not worry in advance. Quite often it happens that a child simply "unravels" on his own. In such a situation, the outcome is quite favorable, and even natural childbirth is possible.
If the nodules on the umbilical cord appeared closer to childbirth, then in this case the possibility of independent "untangling" is rather low. However, even in this situation, the child can be born absolutely healthy. The presence of multiple nodules on the umbilical cord and accompanying indications may lead doctors to resort to a caesarean section.
Obstetricians-gynecologists usually choose a surgical method of obstetrics in the event that the course of pregnancy is complicated by a number of certain conditions. A caesarean section is performed if the presentation is abnormal (or if the fetus is too large). The large size of the baby with a narrow mother's pelvis is also an indication for a cesarean section. In this case, spontaneous childbirth can be very dangerous.
During the passage through the birth canal, the child may become entangled in the umbilical cord or squeeze it strongly. In this case, there is a sudden cessation of blood flow through the umbilical vessels, which can lead to various dangerous conditions, including a threat to the life of the fetus. To avoid such dangerous complications, doctors and resort to performing a cesarean section.
The choice of obstetric tactics for pregnant women with true nodes on the umbilical cord is carried out individually. For this, doctors take into account all the factors affecting the course of pregnancy.
For information on how the fetal circulation proceeds during pregnancy, see the next video.
