23.07.2024

Umbilical cord entanglement of the fetus or limbs

With such a phenomenon as entwining the fetus with an umbilical cord, 25% of expectant mothers face. And naturally, this news becomes an occasion not only for concern, but also for really serious experiences.

Is there a risk for the baby and mother, what is the danger of the wrap, and what to expect during childbirth?

The formation of the umbilical cord begins already from 2-3 weeks of pregnancy. As the crumbs grow, it gradually increases in length.

Types of entanglement of the umbilical cord of the fetus – the main risks when entangling the umbilical cord

This umbilical cord consists of 2 arteries through which blood circulates with products of children’s vital activity, an umbilical vein with the function of transporting oxygen with nutrients, as well as connective tissue.

Thanks to the jelly-like substance called “jelly warton”, the umbilical tissue is resistant even to serious external loads – twisting, squeezing, etc.

The average length of the umbilical cord is 45-60 cm, but it is believed that the length of the umbilical cord depends on genetics, and in some cases it can even reach 80 cm.

In ¼ babies of all expectant mothers, an umbilical cord entanglement is detected, which is not considered a pathology, but requires special attention.

The main types of entanglement of the fetus with the umbilical cord:

The most common form is the entanglement around the neck. It may be…

  1. One time. It occurs most often.
  2. Double. It is also often found and is not dangerous with a net entanglement.
  3. Threefold. An option in which you also should not panic if the doctor says that there is no reason for it.

It also happens…

  • Tight.
  • Or not tight. An option that does not pose a threat to the life of the crumbs.

And also…

  1. Isolated. An option in which the umbilical cord “hooked” only the limbs of the fetus or only his neck.
  2. And combined. In this case, several parts of the body are entangled.

In most cases, specialists diagnose mild cases of entanglement that do not harm children’s health and do not interfere with the normal course of childbirth.

It is also worth noting that it is common for a double and a single entanglement to disappear before childbirth on its own (the baby simply unravels itself).

What is the risk of twisting the neck?

The main risks include the following…

  • Binding the fetus with the umbilical cord and subsequent oxygen starvation, which begins to experience crumbs.
  • Strong umbilical cord tension and subsequent placental abruption (approx. – if the umbilical cord is too short and the cord is tight). Occurs in rare cases.
  • The appearance of microtrauma of the cervical vertebrae.
  • Deteriorated fetal nutrition transport and carbon dioxide withdrawal. As a result, intrauterine growth retardation of the baby.
  • Hypoxia or asphyxia during or before childbirth. In this case, an emergency cesarean section is prescribed.
  • Possible postpartum consequences for the fetus: hypertension and frequent headaches, osteochondrosis, fatigue, etc.

As for the risk of entanglement of limbs (for example, legs), here the percentage of mothers whose pregnancy the entanglement did not affect in any way is even higher, because it is much easier to get the arms and legs out of the umbilical cord.

Therefore, even with ultrasound, usually such cases cannot be recorded.

The main reasons for entwining the umbilical cord neck, limbs or body of the fetus – is it possible to avoid this?

Why does the entanglement arise, and what are the true reasons?

Unfortunately, no one can tell you the exact reason.

But it is believed that entrapment can lead to…
  • Deficiency of oxygen and nutrition. In search of “food” the baby actively moves in the womb, entangled in the umbilical cord.
  • Excessive activity of the fetus, which leads to entanglement of the umbilical cord in the nodule and its shortening.
  • Deficiency of mom’s motor activity.
  • Bad habits of mom. With its abuse of cigarettes or alcohol, the child experiences oxygen starvation. Oxygen deficiency makes the baby move more actively.
  • Mom’s stress and depression. The higher the level of adrenaline in mother’s blood, the higher the activity of the fetus.
  • Polyhydramnios. In this case, the fetus has enough space for movement, and the chances of tangling in the umbilical cord and tightening it increase significantly.
  • The umbilical cord is too long. It also happens.
  • Pathology or disease of the mother. For example, diabetes, any infectious processes, kidney and heart diseases, and so on.

Diagnosis of fetal cord entwining with ultrasound – can there be signs and symptoms of entwining?

If the doctor gives the expectant mother a direction for ultrasound, then neglecting him, of course, is not worth it. It is on an ultrasound scan that the doctor gets the opportunity to monitor pregnancy and the condition of the fetus.

With ultrasound in the early stages it will be possible to determine whether the fetus is entangled with an umbilical cord, and at a later date – whether the baby managed to get rid of the loop.

Also, when entwined, they carry out…
  • Dopplerometry. Usually it is carried out using the same equipment on which an ultrasound scan is performed. This procedure allows you to determine the presence of entanglement, its multiplicity, as well as the state of blood flow in the umbilical cord itself. With the nutritional deficiency noted in the study, the specialist prescribes certain drugs to improve blood circulation.
  • Cardiotocography. This procedure helps to track the mobility of the crumbs and his heart rate. To evaluate the real picture, it takes about an hour, during which experts check – with what frequency the fetal heart beats when it moves. Deviations from the norm may indicate an increasing risk of oxygen starvation.
Important:
  1. In the absence of a life threat to the baby, noted as a result of research, experts do not take any action . Firstly, often the babies themselves get out of their umbilical cord before giving birth, and secondly, the most crucial moment will still come during childbirth. And before birth, only monitoring the condition of the baby is required.
  2. The diagnosis “entanglement”, set at 20-21 weeks, does not pose any threat : the chances of unraveling the umbilical cord independently in a child are still extremely high.
  3. The diagnosis “entanglement” after 32 weeks is also not a sentence and not a reason for panic, but only a reason – to treat your condition more carefully and follow all the doctor’s prescriptions.
  4. Of course, upon admission to the hospital, you should inform your doctor about entrapment (if suddenly such information is not available on the medical record).
By what signs can mom suspect the entanglement on her own?

There are no specific signs – other than those that the doctor discovers from the results of the above procedures – do not exist.

But if you listen to the behavior of your host, you can feel that the baby has become too sluggish – or, conversely, too active.

Any changes in the behavior of the fetus, of course, are the reason – to make an additional visit to your gynecologist!

What to do when entwining the umbilical cord – features of the tactics of childbirth when entwining the fetus with the umbilical cord

Most births with a diagnosis of “entanglement” are easy: the midwife just gently removes the umbilical cord from the infant’s neck (approx. – or legs, arms) when it is born.

With tight entanglement, and even more so with multiple and combined, when the baby is tightly entangled with the umbilical cord, and the risk of hypoxia or even strangulation increases, doctors usually decide on an emergency caesarean section.

During the entire process of childbirth, the baby’s heartbeat is watched especially closely, monitoring every 30 minutes or more often. In addition, they conduct enhanced monitoring using ultrasound and Doppler.

  • With a normal fetal heartbeat, specialists usually decide on natural birth during the entire process of childbirth. If there is a violation of the heart rhythm, the doctor prescribes special medicines designed to stimulate labor.
  • No need to panic that “something will go wrong.” For this emergency case, specialists who, naturally, are aware of the baby’s entanglement with the umbilical cord, are ready to quickly perform a cesarean section and quickly remove the crumbs.
What to do to the mother, who was diagnosed with an ultrasound scan as “entwining the umbilical cord of the fetus”?

First of all, do not panic and do not worry. Mom’s stresses are always harmful to the baby, and when entwined, these mother’s experiences are even more unnecessary (they stimulate the growth of adrenaline in mother’s blood).

Mom is recommended…

  • Eat right – and do not overeat.
  • To live an active lifestyle.
  • Strongly abandon all bad habits.
  • More often walking in the fresh air.
  • Do not be nervous.
  • Do breathing exercises.
  • Ventilate the room more often.

Well, and of course, listen to less “useful tips from friends” about treating entwining with folk recipes. 

Listen to your doctor!

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