The umbilical cord that starts to form at about 4 weeks of pregnancy and usually grows to be about 22 inches long is the life giving connection between the mother and baby. This plays a critical role in providing oxygen and essential nutrients and also in removing fetal waste products. There are certain umbilical accidents that can happen during the course of the pregnancy, labor or during birth that can endanger the life and health of the baby if not identified and appropriately managed. An umbilical cord accident is when there is some sort of restriction of the umbilical cord leading to the baby being cut off from oxygen and other necessities. With all umbilical cord problems, early recognition is critical and action should be quick when there are signs of fetal distress. Fetal distress signs can be recognized through fetal heart rate monitoring and a variety of other prenatal tests.
Some distinct umbilical cord related accidents include;
Umbilical cord compression occurs when pressure prevents the flow of oxygenated blood. The baby can become brain damaged from oxygen deprivation, receive inadequate nutrition, or experience fetal acidosis which is caused by an accumulation of carbon dioxide in the baby’s blood.
An umbilical cord prolapse occurs when the cord drops into the vaginal canal before the baby during delivery. Prolapse usually happens when the amniotic sac breaks too soon, with a premature baby, in the case of multiple births such as twins, excessive amniotic fluid, a breech delivery, or a long umbilical cord. The cord can then become trapped or compressed by the baby’s body.
The cord knots most often because it is too long or in the case of identical twin. Knots in umbilical cords can form early in pregnancy when the baby moves around in the womb. If a knot gets pulled tight, it can cut off the baby’s oxygen causing miscarriage or stillbirth.
A nuchal cord is when the umbilical cord is wrapped around the baby’s neck and this is a common occurrence in one-third of babies. In most cases, the baby will be born healthy and normal but in some instances the cord can cut off blood flow to the brain and harm the baby. Hypoxic-ischemic encephalopathy (HIE) is a form of brain damage caused by oxygen deprivation.
Also known as stricture or overcoiling is when the umbilical cord twists enough times to coil back on itself. This twisting can cut off blood supply or oxygen to the baby.
Short cords are at a risk of stretching and rupturing. When there is a short cord, fetal movement may also cause excessive pulling on the placenta, causing it to tear away from the wall of the uterus (placental abruption). Placental abruption can cause severe maternal bleeding/haemorrhaging and can stop the baby from receiving adequate oxygen.
In this condition the vessels migrate out of the umbilical cord and into the amniotic sac membranes that lie across the opening of the birth canal. These vessels are at risk of rupturing during labor and delivery owing to their position. If the fetal blood vessels rupture, it can lead to massive fetal blood loss and birth injury.
Chorioamnionitis or Intra-Amniotic Infection is an infection of the fetal membranes. When this involves the umbilical cord, this is called funisitis. This is associated with a variety of serious fetal complications, including preterm birth, neonatal sepsis, periventricular leukomalacia (PVL), and cerebral palsy.
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