PASSENGER: CORD COIL
The practitioner can detect a
Nuchal Cord is an umbilical cord wrapped around the
neck of the fetus, if it happens it cause serious problems,
there will be deprivation of oxygen leading to birth
asphyxia complication leading to brain damage.
What causes cord coil?
Random fetal movement is the primary cause of a
nuchal cord. Other factors that might increase the risk of
the umbilical cord wrapping around a baby's neck
include an extra-long umbilical cord or excess amniotic
fluid that allows movement that is more fetal.
Nuchal cords typically are discovered at birth.
What do you do if umbilical cord is wrapped around
baby's neck?
If the cord's wrapped around the baby's neck very tightly,
the midwife may clamp and cut the cord before his
shoulders are born. It's unusual for this to be needed
though. The midwife will be able to tell if there are any
issues with blood flow in the cord from your baby's heart
rate.
When is a nuchal cord dangerous?
If the cord is looped around the neck or another body
part, blood flow through the entangled cord may be
decreased during contractions. This can cause the
baby’s heart rate to fall during contractions. Prior to
delivery, if blood flow is completely cut off, a stillbirth can
occur.
How to avoid nuchal cord?
There's no way to prevent or treat a nuchal cord.
Nothing can be done about it until delivery. Health
professionals check for a cord around the neck of every
single baby born, and usually it is as simple as gently
slipping it off so that it doesn't tighten around the baby's
neck once the baby has started to breathe.
How to know if the cord is wrapped around baby?
It's visible via ultrasound.
nuchal cord about 70 percent of the time during routine
ultrasounds, although it's usually not possible
to determine if the cord is short or tight around the
neck. Baby is suddenly moving less in the last weeks of
pregnancy.
Is normal delivery possible with two loops of cord
around the neck?
Yes. Babies are often born safely with multiple loops of
cord around their necks through normal delivery. In a
few cases when the cord around the neck does not
come off the baby easily, the doctor may decide to
clamp and cut the cord and then deliver the baby.
What are the chances of umbilical cord strangulation?
According to research from the Stillbirth Collaborative
Research Network, umbilical cord accidents account
for around 10% of stillbirths. While people often assume
that the deaths are caused by accidental strangulation,
they are most often the result of a sudden disruption of
the blood supply to the baby
Diagnosis
Nuchal cords can only be diagnosed using an ultrasound,
and even then, they can be very difficult to detect.
Additionally, the ultrasound can only identify the nuchal
cord. Healthcare providers can’t determine from an
ultrasound if the nuchal cord poses any risk to the baby.
If diagnosed with a nuchal cord early in the pregnancy,
it’s important not to panic. The cord may unravel before
birth. If it doesn’t, the baby can still be born safely. If the
health professionals are aware of a potential nuchal cord
during labor, they might suggest extra monitoring so that
they can tell straight away if the baby develops any
complications.
Umbilical Cord Knot. Notice the
area of congestion to the right.
The congested side is always
the side between the knot and
the placenta (Courtesy from
University of Mo. Department of
Pathology)
OBSTETRICAL MANAGEMENT
The obstetrical challenge of the clinical management of
nuchal cords depends upon number of involved nuchal
loops, the amniotic fluid index, the gestational age, and
the fetal growth, among other factors.
Induction of labor considered as independent risk factor
for nuchal cords. A prolonged persistent nuchal cord with
poor fetal growth deserves close monitoring and delivery
as appropriate. Some obstetricians opt to deliver early
when multiple nuchal cord loops are noted on fetal scans.
Presence of variable decelerations during fetal heart rate
monitoring is indicative of possible presence of nuchal
cord.

References
1. Gould GM, Pyle WL. Prenatal anomalies. Anomalies
and curiosities of medicine. New York: The Julian Press,
Inc.; 1896. p. 95. [Google Scholar]
2. Crawford S. Cord round the neck. Incidence and
squeal. Acta Pediátrica. 1962;51:594–603. doi:
10.1111/j.1651-2227.1962.tb06586.x. [PubMed]
[CrossRef] [Google Scholar]
3. Larson JD, Rayburn WF, Crosby S, Thurnau GR.
Multiple nuchal cord entanglements and intrapartum
complications. Am J Obstet Gynecol. 1995;173:1228. doi:
10.1016/0002-9378(95)91359-9. [PubMed]
[CrossRef] [Google Scholar]