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UMBILICAL CORD PROBLEM MOST COMMON UMBILICAL CORD ISSUES THAT
CAN INTERFERE WITH THE HEALTH OF THE
WHAT ARE SIGNS OF UMBILICAL CORD
PROBLEMS?
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 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 a behind
the baby’s belly button.
 Umbilical cord compressed
 Nuchal cords
 True knots
 Umbilical cord prolapsed
 Short umbilical cords
 Vasa previa
 Umbilical cord infection
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
 Sign of umbilical cord compression may
include less activity from the baby,
observed as a decrease in movement,
or an irregular heartbeat, which can be
observed by fetal heart monitoring.
 Common causes of umbilical cord
compression include: nuchal cords. True
knots, and umbilical cord prolapsed
NUCHAL CORD
 Nuchal cord is the medical term when
an umbilical cord becomes wrapped
once or more times around the baby’s
neck within the womb. Nuchal cord
with one loop of cord around the baby’s
neck may occur in approximately 20%
of deliveries.
 Nuchal cord is usually caused by the
baby’s movement through a loop of the
umbilical cord. Nuchal cord may be
detectable by electronic fetal heart
monitoring. Certain patterns of the
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baby’s heart, like variable
decelerations” of the heart rate, are
often associated with nuchal cord.
Nuchal cord may sometimes be
visualized on color Doppler ultrasound.
UMBILICAL CORD PROLAPSED
 Before or during birth, the umbilical
cord can drop through the open cervix
into the vagina ahead of the baby. This
complication, called umbilical cord
prolapsed, must be dealt with
immediately so the fetus doesn’t put
pressure on the cord, cutting off oxygen
WHAT IS UMBILICAL CORD PROLAPSED?
 This condition occurs when the
umbilical cord drops (prolapsed)
between the fetal presenting part and
the cervix into the vagina. Umbilical
cord prolapse occurs prior to or during
delivery of the baby. The overall
incidence is reported at 0.16%-0.18% or
approximately one in every 300 births.
COMON CAUSES UMBILICAL CORD PROLAPSE
INCLUDE:
 Premature rupture of membranes
 Pretern labor
 Multiple gestation pregnancies (twins,
triplets, etc.).
 Polyhydramnios (excessive amniotic
fluid)
 Malpresentation of fetus (breech
presentation)
HOW IS AN UMBILICAL CORD PROLAPSE
DIAGNOSED
 Umbilical cord prolapse is diagnosed by
seeing or palpating the prolapsed cord
on pelvic exam. In addition, the baby
may have an abnormal fetal heart rate
known as bradycardia (a heart rate of
less than 120 beats per minute)
HOW IS AN UMBILICAL CORD PROLAPSE
MANAGED?
 Umbilical cord prolapse is an acute
obstetric emergency that requires
immediate delivery of the baby. The
route of delivery is usually by caesarean
section. The doctor will relieve cord
compression by manually elevating the
fetal presentation part until caesarean
section is performed. This reduces the
risk of fetal oxygen loss.
 If the problem with the prolapsed cord
can be solved immediately, there may
be no permanent injury. However, the
longer the delay, the greater the chance
of problems (such as brain damage or
death) for the baby.
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WHAT HAPPENS IF THERE IS A KNOT IN THE

UMBILICAL CORD?

 Most knots don’t cause problems for

our baby. As long as the knot isn’t too
toght, blood flow and nutrients aren’t
restricted. However, a tight knot leaves
your baby without enough oxygen and
puts them at risk for brain damage and
even stillbirth.

TRUE KNOTS

 True knots are the medical term for

when the umbilical cord gets twisted
like a rape 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 amnioticfluis) overly long
umbilical cords, smaller that normal
fetuses, gestational diabetes, and
amniocentesis (a procedure to test the
amniotic fluid). True knots also can
form more often in male fertuses 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 proffesionals should
remain alert for decreased activity and
should test for umbilical cord problems
as needed.