An umbilical cord may become compressed or damaged before or during childbirth. Common signs of umbilical cord problems include an irregular fetal heartbeat and decreased or low fetal movement. Umbilical cord problems can be a serious threat to the child’s health and should be carefully monitored and treated as necessary.
The information in this post was compiled from government, educational non-profit, and medical expert sources.
Keep reading to learn about the signs of umbilical cord problems.
The Umbilical Cord Delivers Oxygen to the Baby
Before exploring the common problems with umbilical cords, we should first examine why the umbilical cord is so important.
The umbilical cord connects the mother to the baby as the baby develops in the womb. The umbilical cord starts at the mother’s placenta and connects to an opening in the baby’s stomach.
During pregnancy, the umbilical cord delivers vital nutrients and oxygen from the mother to the baby. The umbilical cord has one vein and two arteries surrounded by a protective layer. The protective layer is made up of a substance called Wharton’s jelly and wrapped in a membrane called the amnion.
The vein delivers blood full of nutrients and oxygen to the baby, while the arteries remove deoxygenated blood and waste from the baby back to the placenta.
After the baby is born, the umbilical cord is clamped and cut. There are no nerves within an umbilical cord, so this is not painful for the baby or for the mother. Within a couple of weeks, the clamped stump of the umbilical cord will eventually fall off, leaving behind the baby’s belly button.
In summary: if the proper function of the baby’s umbilical cord is vital to deliver nutrients and oxygen to the baby.
Most Common Umbilical Cord Problems
Here are some of the most common umbilical cord issues that can interfere with the health of the baby:
- Umbilical cord compression
- Nuchal cords
- True knots
- Umbilical cord prolapse
- Short umbilical cords
- Vasa previa
- Umbilical cord infection
In the next sections, we will learn about the signs of each problem and what each problem means for the baby.
Umbilical Cord Compression
One common umbilical cord problem is due to compression. Compression occurs when pressure partially or completely stops the flow of blood through the umbilical cord. Babies can survive short periods of umbilical cord compression, but if an adequate flow of blood to the baby is not re-established, the baby may suffer serious birth injuries. As we covered in the previous sections, this condition is dangerous because babies need nutrients and oxygen to remain healthy during development.
Signs of umbilical cord compression may include less activity from the baby, observed as a decrease in movement, or an irregular heart beat, which can be observed by fetal heart monitoring.
Common causes of umbilical cord compression include: nuchal cords, true knots, and umbilical cord prolapse.
Nuchal cord is the medical term for when an umbilical cord becomes wrapped once or more times around the baby’s neck within the womb. Nuchal cords are a surprisingly common condition, occurring in as many as 35% of pregnancies. A nuchal cord becomes dangerous when the cord wraps tightly around the baby’s neck, often during labor and delivery, and the flow of blood to the baby is interrupted.
In a dangerous situation caused by a nuchal cord, a c-section delivery may be necessary to quickly deliver the baby before the lack of blood flow causes the baby to suffer a permanent injury. Common injuries that can be caused by nuchal cords include birth asphyxiation, HIE, and Cerebral Palsy.
True knots are the medical term for when the umbilical cord gets twisted like a rope into a knot. True knots can form simply by the baby’s movement within the mother’s womb. Other causes can include monoamniotic twins (when twins share the same amniotic sac), polyhydramnios (excessive amounts of amniotic fluid), overly long umbilical cords, smaller than normal fetuses, gestational diabetes, and amniocentesis (a procedure to test the amniotic fluid). True knots also can form more often in male fetuses or when the mother has had several previous pregnancies.
If a baby’s activity decreases after 37 weeks, that is a common sign of a true knot. Medical professionals should remain alert for decreased activity and should test for umbilical cord problems as needed.
Medical professionals can check for a reassuring heartbeat from the baby and monitor the baby’s activity to determine whether further intervention is required.
Umbilical Cord Prolapse
A prolapse means that the umbilical cord has moved down the birth canal before or along side of the baby. Ideally, the umbilical cord should follow the baby out through the birth canal. If the cord gets ahead of the baby or moves along side the baby, a dangerous situation can develop leading to birth asphyxia, HIE, and other birth injuries.
If a mother or a medical professional becomes aware of a possible cord prolapse, the medical professionals should take immediate steps to monitor and intervene as necessary–particularly if the prolapse occurs within the third trimester. By carefully monitoring the situation and by delivering the baby by c-section, potential serious injuries may be avoided.
In summary: umbilical cord compression can be caused by nuchal cords, true knots, and umbilical cord prolapse. In all of these circumstances, medical professionals must carefully monitor the baby’s health. If necessary, the medical professionals should consider ordering an emergency c-section to prevent further injury.
Short Umbilical Cords
If the baby’s umbilical cord is short the baby’s movements may stretch and tear either the umbilical cord or the mother’s placenta (known as placental abruption). Ideally, an umbilical cord should be long enough for the baby to move without stretching the cord, but not so long as to easily get knotted or tangled.
If a short umbilical cord causes placental abruption, the mother may hemorrhage a lot of blood, which can be harmful to both the baby and the mother. Medical professionals should be prepared to perform a c-section or an operative delivery with forceps or a vacuum extractor if necessary (although forceps and vacuum extractor methods can also be dangerous and should not be attempted if the medical professional is not well trained and experienced with these methods).
Vasa (from the latin for vessels) previa (from the latin for before) is a condition where the fetal blood vessels move out of the umbilical cord and into the amniotic sac membranes across the birth canal. In this position, the vessels are at risk for rupture during labor and delivery, which can lead to massive blood loss and permanent injury of the baby.
If vasa previa is detected, medical professionals should consider an early c-section to prevent potential birth injuries. If the blood vessels are ruptured during delivery, a blood transfusion may be necessary immediately after birth.
Umbilical Cord Infection
When the fetal membranes become infected, that infection can spread to the umbilical cord, the placenta, the fetus, and the amniotic fluid. This is called an intra-amniotic infection, or an IAI.
An IAI or an infection of the umbilical cord is called funisitis. An infection of the umbilical cord can potentially lead to fetal inflammatory response syndrome, or FIRS, and can cause pre-term birth, neonatal sepsis, periventricular leukomalacia, and Cerebral Palsy.
Antibiotics can potentially prevent a serious birth injury from occurring.
Treatment for Umbilical Cord Based Injuries
As we’ve already discussed in this article, careful monitoring, an early c-section or operative delivery, along with blood transfusions are all potential treatment strategies to prevent injuries caused by umbilical cord problems.
An additional treatment strategy that becomes available once the child has been delivered is cooling therapy. Cooling therapy can be used shortly after birth to try and slow or stop permanent injuries caused by lack of blood flow to the brain.
<a href="https://browntrialfirm.com/" target="blank"><img src="https://browntrialfirm.com/infographics/infant-cooling-therapy-btf.jpg" alt="Cooling Therapy Infographic" title="" style="width: 100%; max-width: 800px; display: block; margin: 15px auto;" /></a>
Infant Cooling Therapy
6-24 hour window
Infant cooling therapy is typically applied within six hours of birth. Some new studies suggest it may be effective up to 24 hours after birth.
Blanket or cap
Cooling therapy is applied by either placing the baby on a cooling blanket or by placing a cooling cap on the baby’s head.
33 C / 91.4 F
The baby’s body temperature is cooled down to 33c or 91.4f in an effort to slow down or prevent potential brain injuries.
2 – 3 days
Although treatment may vary from case to case depending on severity, two to three days is a typical length for cooling therapy to be applied.
What is the umbilical cord?. (2018). nhs.uk. Retrieved 17 February 2020, from https://www.nhs.uk/common-health-questions/pregnancy/what-is-the-umbilical-cord/
Umbilical cord conditions. (2020). Marchofdimes.org. Retrieved 17 February 2020, from https://www.marchofdimes.org/complications/umbilical-cord-conditions.aspx
What happens if the umbilical cord is around my baby’s neck? | Your Pregnancy Matters | UT Southwestern Medical Center. (2020). Utswmed.org. Retrieved 17 February 2020, from https://utswmed.org/medblog/nuchal-cord-during-pregnancy/
Contact a Cerebral Palsy and Birth Injury Attorney
Getting help for a child with a birth injury can make a big difference. Early intervention and early treatment is often key to helping improve a child’s wellbeing. You must act quickly.
If you have questions about whether your child’s birth injury was caused by a preventable medical error, then our attorneys at Brown Trial Firm may be able to help.
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If you would like help investigating your child’s birth injury, please contact us. Our birth injury attorneys will be happy to give you a free case evaluation. We can also point you to great non-legal resources that can help you figure out your next steps.
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