The medical term that describes the situation in which the umbilical cord is wrapped around the fetus’s neck is a nuchal cord. It rarely causes complications, so healthcare providers can safely slip the cord over the baby’s head during delivery.
The umbilical cord is a long and flexible tube-like structure that connects the placenta to the fetus during pregnancy. It delivers oxygen, blood, and nutrients to the developing baby. While it can be scary to hear that the umbilical cord is wrapped around the baby’s neck, it almost never causes complications during pregnancy or after birth.
Types of Nuchal Cords
Healthcare professionals often use the following terms to describe the nuchal cord. For example:
- Single nuchal cord – In such cases, there is one loop of the umbilical cord around the baby’s neck.
- Multiple nuchal cords – This type means there are multiple than one loop of umbilical cord around the baby’s neck.
Sometimes, they may also describe the nuchal cord as “loose” or “tight”. Usually, a loose nuchal cord comes undone by fetal movement during pregnancy, and they occur more commonly than tight nuchal cords. The tight nuchal cords are more likely to cause complications.
How Common Are Nuchal Cords?
About 25% of babies (1 in 4) are born with a single nuchal cord, which is common. However, approximately 2.4% to 8.3% of babies (2 to 8 out of 100 babies) are born with two or more loops (also called multiple nuchal cords).
Symptoms
Usually, the symptoms of a nuchal cord can be noticed during pregnancy. One of them is variable decelerations in fetal heart rate monitoring. It means the baby’s heart rate drops below the healthy rate. In general, variable decelerations mean a blockage of blood flow through the umbilical cord, but it may also mean there is a compression of the vessels within the cord. Mostly, this compression is caused by a nuchal cord. However, a compression of the vessels may also occur due to a knot in the cord or umbilical cord prolapse.
In most cases, healthcare professionals act quickly to keep you and your baby safe if they notice fetal heart rate decelerations.
Causes and Risk Factors
This situation often occurs randomly. Check below some factors that significantly increase the risk of a nuchal cord:
- Excessive fetal movement
- Long umbilical cord (over 27 inches long)
- Polyhydramnios (large amounts of amniotic fluid)
Unfortunately, there is no way to manage these risk factors, but you should understand that it is not your fault if your baby has a nuchal cord when they are born.
What Are The Possible Complications of a Nuchal Cord?
While a loose nuchal cord rarely causes complications, your healthcare professional may slip the loop over the baby’s head when it comes through the birth canal. However, babies with a tight nuchal cord are at increased risk of developing the following complications after birth. Check some of them below:
- Subconjunctival hemorrhage (broken blood vessel in the eye)
- Hypotension (low blood pressure)
- Hypovolemia (low blood volume)
- Respiratory distress (mild breathing problems)
- Facial petechiae (these are small spots of bleeding under the skin)
- Skin abrasions around the neck
- Temporary face discoloration
In rare cases, babies with nuchal cords may experience more severe complications. Examples include:
- Anemia (low red blood cell count)
- Acidosis (acidic blood)
- Severe blood loss
- Cerebral palsy (impaired motor skills and movement)
- Organ damage
- Neurological problems (including epilepsy, learning disabilities, behavioral issues, seizures, and others)
This document does not contain a full list of complications. However, you can consult with your healthcare professional about ways to reduce the risk or even prevent them.
Is There a Way to Prevent an Umbilical Cord Around the Neck?
There is no way to prevent a nuchal cord because it occurs randomly during pregnancy. Moreover, doctors often notice a nuchal cord during delivery.
Diagnosis
In some cases, doctors identify a nuchal cord during pregnancy while performing a routine ultrasound test. However, not all doctors report their findings because it is considered normal and may cause concerns to the pregnant woman. Your doctor should make sure the blood is flowing properly through the umbilical cord. It can be checked through a Doppler ultrasound.
Furthermore, your doctor may check for a nuchal cord with a physical test before delivery. Usually, it involves applying pressure to the fetal neck area through the abdomen (belly). When the pressure results in a drop in fetal heart rate, it means there is a risk of umbilical cord compression. Therefore, doctors will monitor the fetal heart rate to act quickly if a complication occurs.
Treatment
Unfortunately, there is no way to fix a nuchal cord during labor, but doctors may look for umbilical cord problems with fetal heart rate monitoring during labor and delivery. When there are drops in fetal heart rate, doctors may recommend the following options. Examples include:
- IV (intravenous) fluids
- Oxygen therapy
- Changing your position (for instance, turning from one side to another)
Commonly, doctors are able to slip the umbilical cord over the baby’s head if there is a loose nuchal cord. When the nuchal cord is too tight, doctors may use the somersault maneuver to deliver the baby. During this procedure, doctors will position your baby in a way that keeps their head close to the pelvic area, which allows the cord to not pull as much on your baby’s neck.
Frequently Asked Questions
Can a baby with a nuchal cord be delivered normally?
Most of the time, the nuchal cord does not cause any problems, which means you can deliver the baby as planned. Rarely, a tight nuchal cord may block blood supply through the umbilical cord, causing fetal distress. When it occurs, people often need an emergency C-section. However, if your baby is in breech position and has a nuchal cord, physicians may not recommend doing an external cephalic version (ECV) or vaginal delivery.
Should I be worried about a nuchal cord?
Most of the time, nuchal cords are not a concern. Moreover, they are not linked to stillbirth or other serious complications. Nowadays, most healthcare professionals know how to manage a nuchal cord.
Can a baby be born healthy with a nuchal cord?
Yes, most babies with nuchal cords are born healthy. Furthermore, many nuchal cords resolve on their own prior to delivery or are loose enough that physicians can easily maneuver away from the baby’s neck. If you have additional questions, ask your healthcare provider.
