One end of the umbilical cord is connected to the mother and the other end is connected to the baby. The mother continuously delivers nutrients to the baby through the umbilical cord. It is the baby\’s nutritional belt and also the baby\’s life belt. Umbilical Cord – Once this busy passage is blocked or interrupted for any reason, it can have serious or even fatal effects on the fetus. But what should a pregnant woman do if the umbilical cord is not functioning properly? Come and hear about the umbilical cord knowledge about Lucky Pregnancy Grass.
Xiaozhuzi: My wife went to the hospital for a B-ultrasound when she was eight months old. The doctor said the umbilical cord was wrapped around the baby\’s neck. The doctor said it was fine, but I was still worried. I\’d like someone who knows to tell me if this is true. Can affect the fetus. Urgent! Urgent! Urgent!
Umbilical cord hazard 1: Umbilical cord entanglement
There are many problems that can occur with the umbilical cord. Among them, the umbilical cord around the neck is most likely to occur and is also the most troublesome problem for expectant mothers. With the development and widespread application of ultrasound technology, it is no longer difficult to find the umbilical cord around the neck. Once an expectant mother learns that her baby has the umbilical cord wrapped around her neck, she will inevitably panic. It is difficult to generalize whether panic about a baby being in danger is warranted.
Frequency of umbilical cord wrapping around the neck According to statistics, about 20% to 25% of fetuses have the umbilical cord wrapping around the neck. Only a few fetuses suffer from hypoxia or death due to the umbilical cord wrapping around the neck. That is, although a quarter of babies have their umbilical cords bypassed, the vast majority are born safely. It can be seen that excessive worry is unnecessary.
Dangers of umbilical cord wrapped around neck
Why is the umbilical cord wrapped around the neck? What are the dangers in these situations? Let\’s imagine this.
In the second trimester, the baby is floating comfortably in the warm amniotic fluid of the mother\’s womb, and the umbilical cord is also floating. When the baby reaches a certain level of development, he will move around in the amniotic fluid, stretch his hands and feet, and even do somersaults. The umbilical cord can coexist peacefully, but if you are not careful, your hands, feet or body can become entangled in the umbilical cord. When the space is big enough, he can turn over and come out, so sometimes the ultrasound shows that the umbilical cord is wrapped around the neck, and the next time it is not found.
As the baby grows up, the amniotic pool becomes relatively smaller for him and he cannot move much. At this time, if the umbilical cord is wrapped around the neck, it will not be so easy to take off. Fortunately, the umbilical cord comes in a certain length. Most of the time, the umbilical cord wraps around your baby\’s neck like a loose scarf. Danger. If the umbilical cord is not long enough, or if a naughty baby wraps it around the neck several times, the umbilical cord will tighten, affecting the baby\’s blood supply, and danger will come quietly. Due to the pressure on the umbilical cord, the supply of nutrients and oxygen is reduced, and the supply required for the baby\’s growth is insufficient. Fetal growth retardation and even fetal distress may occur.
abnormal umbilical cord
Another danger occurs during childbirth. During natural labor, the fetus descends through the dilated cervix and down the birth canal under the pressure of uterine contractions. As the fetus gradually descends, the umbilical cord gradually tightens.
Normally, the umbilical cord is long enough to deliver the fetus safely. If the umbilical cord is wrapped around the neck, its length will be relatively reduced and it may be too tight, causing fetal hypoxia.
Diagnosis and treatment
When the umbilical cord is entangled, you can confirm whether there are umbilical cord marks on the fetus through B-ultrasound before delivery. An experienced B-ultrasound doctor can accurately measure the number of weeks the umbilical cord is wrapped. To check whether entanglement affects fetal health, fetal electronic monitoring can be used to observe changes in fetal heart rate. If there are irregular decelerations or excessive changes in the fetal heart rate, it should be considered that the umbilical cord is being stretched or squeezed.
The treatment of umbilical cord entanglement is mainly determined based on the progress of labor and the impact of the entanglement on the fetus. When the labor process begins, the fetus is already hypoxic and a cesarean section should be performed immediately. If abnormalities are found during the second stage of labor, the fetus should be delivered as soon as possible. If the umbilical cord is found to be too tight during delivery, the umbilical cord should be clamped and cut immediately.
Cord hazard #2: Prolapsed umbilical cord
One abnormality in the umbilical cord is very critical, and that is umbilical cord prolapse.
We know that the normal fetal position is cephalic, that is, the fetus is head-down. When the fetal position is abnormal or the fetus is too small, the umbilical cord can easily slip through the gap to the lower part of the fetus. At this time, once the fetal membranes rupture prematurely, the umbilical cord will slide down first. If contractions occur, the umbilical cord will be strongly compressed, and the blood supply to the fetus will be sharply reduced or even interrupted, causing severe asphyxia or even death of the fetus in a short period of time.
What should I do if the umbilical cord prolapses during delivery?
If the fetal membranes are intact and the umbilical cord is below the fetal presentation, it is called umbilical cord presentation; if the fetal membranes rupture and the umbilical cord protrudes below the cervix, it is called umbilical cord prolapse. Umbilical cord prolapse often occurs when the fetal position is abnormal, such as transverse position, breech position, polyhydramnios, pelvic stenosis or cephalopelvic disproportion.
It often occurs in patients with polyhydramnios. When the fetal membranes suddenly rupture, the umbilical cord rushes out with the amniotic fluid, or the femoral membranes rupture prematurely, and the fetus has not yet entered the pelvis. Umbilical cord prolapse itself has no impact on the mother, and the risk to the mother is mainly the factors that induce prolapse. Moreover, because the fetus is in urgent need of rapid delivery, the surgical delivery rate has increased significantly, and the chances of maternal injuries such as cervical and vaginal tearing and infection have also increased accordingly.
This is different for the fetus. The life of the fetus is seriously threatened, and the mortality rate is extremely high, as high as 40%. Foreign coverage ranged from 9% to 49%. Prognosis is significantly related to the time from onset of prolapse to delivery. The time from the fetal heart rate starting to decrease to the delivery of the fetus is within 20 minutes, and the prognosis is better. Otherwise, the mortality rate will be high, and survivors may have neurological sequelae. Early detection and treatment of umbilical cord prolapse is key.
Treatment of umbilical cord prolapse during childbirth
1. If the window has been completely opened, the fetus is alive, there is no head droop, and the presenting part is very low, the head position can be operated with tweezers, and the breech position can be treated with breech traction.
2. The window is not fully opened, noQualified for vaginal delivery and convincing. If family members are present, obtain their consent. When they are not present, they can explain the situation to the pregnant woman. After obtaining consent and/or signature, a cesarean section is performed immediately. At this time, the pregnant woman\’s head is lowered, and the examiner uses the vaginal examination hand to push the fetal head upward to separate it from the umbilical cord and reduce the pressure on the umbilical cord. The cesarean section is performed quickly under local anesthesia. But be sure to listen to the fetal heart rate again before disinfecting the skin. If the fetal heart rate is 100 beats/min, caesarean section should be performed with caution.
3. If the femoral heart and umbilical cord pulses have disappeared and the fetus is dead or dying, it is a normal birth.
4. After delivery, the length of the umbilical cord should be measured and checked for a low-lying placenta.
Umbilical cord danger three:
Umbilical cord is too long
The average length of the umbilical cord of a normal full-term fetus is 55 cm. If it exceeds 70 cm, it is called an umbilical cord that is too long, and if it is less than 30 cm, it is called an umbilical cord that is too short. An excessively long umbilical cord can easily lead to complications such as umbilical cord entanglement, knotting, prolapse, and compression of umbilical blood vessels.
If the umbilical cord is too short, neither the mother nor the fetus will have symptoms during pregnancy. However, during delivery, the umbilical cord may be too short, causing difficulty in fetal descent, or the umbilical cord may be pulled too tightly, causing fetal distress or fetal distress. Placental abruption.
Diagnosis and treatment
Early diagnosis of excessively long umbilical cord can be made by observing changes in fetal heart rate through B-ultrasound and electronic monitoring. An excessively long umbilical cord itself does not require treatment. Only when the umbilical cord is too long causes Complications such as tangles, knots, and prolapse require treatment. If the umbilical cord is too short, it is difficult to diagnose even with B-ultrasound examination. If there is difficulty in fetal descent or prolonged labor during delivery, the fetal heart rate should be closely observed. If abnormalities in the fetal heart rate are found, fetal distress caused by umbilical cord factors can be diagnosed early. Once these occur, If the problem occurs, a cesarean section should be performed immediately. If the abnormality occurs after entering the second stage of labor, the baby can be delivered vaginally quickly, and the umbilical cord should be clamped and cut immediately after the fetal shoulder is delivered.
Umbilical cord danger 4: Umbilical cord torsion
Umbilical cord torsion means that the umbilical cord rotates and twists along the longitudinal axis, just like twisting a hemp rope. It can return to normal as long as it is rotated in the opposite direction. .
The occurrence of umbilical cord torsion is related to fetal activity. Under normal circumstances, umbilical cord torsion can occur, but it should not be twisted too much or too densely. Excessive torsion can interrupt blood circulation and increase fetal mortality. Diagnosis and Treatment When severe umbilical cord torsion occurs, fetal movements first become more frequent and then disappear. Therefore, those with abnormal fetal movements should pay attention. If umbilical cord torsion is suspected, the decision should be made based on whether the fetus is hypoxic and the stage of pregnancy.
Umbilical cord danger five: Umbilical cord knotting
There are two types of umbilical cord knotting. One is umbilical cord false knot, which is caused by the inconsistency between the length of the umbilical blood vessels and the umbilical cord and the twisting of the blood vessels in the umbilical cord. It is not a real knot, and the false knot cannot be tightened, which is not harmful to the fetus.
The other type is the true knot of the umbilical cord, which is related to fetal activity. It usually occurs in the second trimester of pregnancy. First, the umbilical cord wraps around the body, and then the fetus passes through the umbilical cord around the body.Forming a knot in the umbilical cord. If the knot is not tightened, it will have no effect on the fetus. If it is tightened, it will block blood circulation and cause intrauterine asphyxia, or cause stillbirth during delivery.
Umbilical cord danger 6: Single umbilical artery
There are two umbilical arteries and one umbilical vein in the normal umbilical cord. If the embryo develops abnormally and there is only one umbilical artery in the umbilical cord, it is called a single umbilical artery. Obviously, when there is a single umbilical artery, the fetus receives less blood flow than normal, which increases the chance of premature delivery, growth retardation, and intrauterine hypoxia. Diagnosis and treatment can now mostly be confirmed through prenatal B-ultrasound examination.
There is currently no treatment for this abnormality. The condition of the fetus should be paid close attention to. If the fetus does not suffer from ischemia or hypoxia, the pregnancy can continue until delivery.