Future mother 

Tight entanglement of the umbilical cord around the neck during childbirth. We understand the details: cord entanglement, causes and consequences. Cord entanglement: causes

After successful fertilization occurs, and the tiny fetal egg is safely attached to the uterine cavity, it becomes necessary to form the most important connecting elements between the growing fetus and, of course, the expectant mother. This is exactly what is inextricably linked, the umbilical cord and. They finish their main formation, as a rule, closer to the 14th week.

The placenta performs many functions that are vital for the full intrauterine development of the baby. The umbilical cord, in turn, helps to get everything necessary from the mother's body, in particular, oxygen and all kinds of nutrients, for the normal growth and development of the fetus.

This long cord extending from the placenta, approximately from its center, has a certain size. Normally, the length of the organ corresponds to 40 - 60 cm, the thickness is about 2 cm. Sometimes, for various reasons, the umbilical cord is twisted around the baby. This can be seen with an ultrasound. There are different types of wrapping. Some of them are very dangerous for the fetus, which often causes anxiety and anxiety among expectant mothers.

The structure of the umbilical cord: features

The unique organ that is the umbilical cord has two ends. One is attached to the fetus in the tummy area, and the other, respectively, to the placenta. In addition, the umbilical cord has a special structure. These are three large vessels protected by a jelly-like substance. Vessels - a vein and two arteries, provide good nutrition, and on the other hand, the output of metabolic products of the fetus.

"Wharton's jelly", as it is also called, the substance located between and around the vessels, protects them from deformation. Therefore, the more it is, the less the vein and arteries are exposed to undesirable effects. This has a positive effect on the blood passing through them, respectively, providing good nutrition for the baby, and hence its normal development.

The umbilical cord can be of different sizes. By the end of pregnancy, it grows to an average of 60 - 70 cm in length. The thickness corresponds to approximately 2 cm. The umbilical cord, due to its unique structure, can withstand, and without any harm to the baby, significant loads. But deviations are not excluded, which can sometimes become a problem not only during pregnancy, but also during childbirth.

Umbilical cord problems and the threat of loops in the neck

Each pregnancy is special and the development of the baby, including intrauterine, occurs, of course, completely individually. There are no exceptions for the placenta or the umbilical cord. Naturally, there are certain standards. For example, regarding the length of the umbilical cord. If its length is more than 70 cm, then this is already considered a deviation. An umbilical cord shorter than 40 cm can also become a problem for the normal development of the fetus, and especially during childbirth.

An increase in the length of the umbilical cord can cause various pathological conditions. An overly long cord is able to wrap around the baby's neck, his torso, limbs. The formation of so-called umbilical cord nodes is very dangerous. They are divided into two groups. These are true and false nodes. The true ones are just that most dangerous pathology that can lead to the most detrimental consequences.

The baby spends its intrauterine development not only in the resting stage. He, of course, moves inside his mother's tummy. The stronger his movements, the more likely he is to confuse his neck with the umbilical cord. The activity of the fetus depends on several reasons. First of all, this is the possible formation of such an undesirable pathology as hypoxia. Simply put, insufficient intake of oxygen into the baby's body can provoke its increased activity, which becomes one of the reasons for entanglement with the umbilical cord.

The entanglement can also occur due to. The fetus has more room to move, which means that the likelihood of confusing itself with the umbilical cord increases.

Affects the mobility of the baby and the nutritional regime of the expectant mother. His activity can be stimulated by the use of stimulating drinks by the mother, for example, strong tea or coffee. The reaction can also occur to an excess of spices and garlic in food. Even an excess of chocolate and cocoa drinks can excite the baby.

Don't discount stressful situations. The fetus is very susceptible to the states of the mother of the emotional, mental plan. Adrenaline and other stress hormones have an extremely negative effect on the behavior of the fetus, causing it to be anxious, agitated.

Not the last role is played by the size of the umbilical cord. If it is too long, then this allows the baby to freely manipulate it, wrapping not only the neck, but the whole of itself.

According to statistics, about 20% of all newborns are born wrapped in an umbilical cord. Not all cases end tragically. However, there are many myths and signs that excite the minds of expectant mothers.

One of the fairly common myths is the categorical refusal during pregnancy of certain types of purely female work, namely, weaving, knitting, sewing. Allegedly, these processes contribute to the emergence of a dangerous pathology - the entanglement of the baby with the umbilical cord. Yes, in the old days, some trend may have existed. But her reason was quite different.

In those days, people lived in dark, stuffy dwellings, which were heated with wood-burning stoves. A pregnant woman, despite her special position, sewed, and knitted, and wove in such a house. Insufficient oxygen supply to the mother's body adversely affected the well-being of the unborn baby. From this, he experienced hypoxia and, accordingly, began to move more actively, involuntarily wrapping himself with the umbilical cord.

A modern mom should not give up such exciting and interesting activities as sewing or knitting. The main thing is not to overwork and spend more time in the fresh air.

Another myth does not allow a pregnant woman to often raise her arms high above her head, since such a position can also lead to dangerous pathology. Indeed, great physical exertion, when alternatives to hand washing in the form of a washing machine and plumbing had not yet been invented, a woman often overworked.

Lifting weights while carrying water, hand washing itself, raising hands when hanging laundry, all this could adversely affect the body of a pregnant woman, provoke an increase in uterine tone, and the appearance of hypoxia in the fetus. The baby tried to compensate for the lack of oxygen by strengthening its intrauterine movements. Accordingly, cord loops could form around it.

The modern way of life, most often, sedentary work, a private car, a washing machine and all kinds of other kitchen and household appliances, allow a woman to be less physically loaded. Therefore, doctors, on the contrary, recommend that pregnant women increase their physical activity. Moreover, there are more and more new methods in which the alleged physical activity has a beneficial effect not only on the mother, but also on her unborn baby.

Medical experts believe that the entanglement of the umbilical cord of the fetus, including its neck, in the early stages has practically no reason for concern. A baby during pregnancy can become entangled in the umbilical cord several times and free itself from it.

If the pregnancy has crossed the 32-week mark, and the entanglement remains, then such a pathology is already in the category of dangerous ones. Especially if the entanglement has several loops and tight tension. In such cases, constant monitoring of the condition of the fetus is carried out, and the tactics of childbirth are preliminarily determined.

External manifestations, symptoms of entanglement

Usually, there are no direct external manifestations that would indicate the entanglement of the fetus with the umbilical cord in the expectant mother. Physicians may suspect pathology by indirect signs. If the pregnancy is singleton, and the belly of the expectant mother is not moderately large, then this most likely indicates polyhydramnios. With such a diagnosis, the baby may well wrap the umbilical cord around itself.

Another symptom is excessive fetal mobility. Due to hypoxia, which may be the result of the umbilical cord entwining the baby, he tries to change position and therefore the expectant mother has no rest day or night. These symptoms can alert both the pregnant woman and the doctor observing her. As a rule, in such cases, an additional examination is prescribed.

How doctors detect entanglement

To establish an accurate diagnosis in case of suspected entanglement and to determine the current state of the fetus, a whole range of studies is expected. First of all, the pathology can be seen, as a rule, during an ultrasound examination. Although in some cases, it is not possible to find out exactly where the loops are, namely, near the neck or directly around it, even with the help of this rather innovative medical equipment.

This is due to the impossibility of the image in a three-dimensional format. With such a study, the baby can only be seen from the side that he is turned to the screen. More or less accurate data with such an examination can be obtained only from the 2nd trimester.

Another method is doplerometry. Just thanks to its color image of blood flows, it is possible to determine exactly where the umbilical cord is located and, accordingly, whether there is an entanglement. In addition, the method is also useful in that the blood flow velocity is also determined in the vessels of the entire uterine-placental complex.

This makes it possible to assume the degree of fetal hypoxia, if any, other pathologies, the cause of which may be a tight entanglement. These studies are recommended to be carried out in dynamics, since due to the constant movement, the position of the umbilical cord and, accordingly, the entanglement may change.

At the 33rd week of pregnancy, the use of cardiotocography is considered effective. With the help of special sensors that are attached to the belly of a pregnant woman, they receive data (a curve) indicating the work of the baby's heart. If the entanglement exists, then with stirring, the heart rate, as a rule, decreases.

Only after passing the whole complex of studies, specialists can determine the condition of the baby and make the right decision regarding delivery.

If an entanglement of the fetus with the umbilical cord, or rather its neck, is detected, an additional examination of the baby's condition is expected. If it is satisfactory and no pathologies, in particular hypoxia, are detected, then childbirth can go on as usual. As a rule, this is possible with a single and very weak tension of the umbilical cord around the fetal neck. However, some precautions must be taken to avoid negative consequences.

So, at the first stage of delivery, first of all, it is necessary to control the heartbeat of the fetus every half an hour. In the second period, such manipulation is carried out after each attempt. If the heart rate decreases, then the stimulation of the birth process is possible. As soon as the baby's head passes through the birth canal, the neck is immediately, but very carefully, released from the umbilical cord.

With tight or repeated entanglement, the fetus may still suffer from a lack of oxygen in utero. During childbirth occurring naturally, the situation is aggravated. The umbilical cord at the time of the release of the baby can be strongly stretched, which is fraught with clamping of the vessels through which oxygen and nutrients enter the child. So in this situation, not only hypoxia, but also suffocation can occur. Another danger is placental abruption, meaning premature, as well as bleeding. These pathologies can also lead to the death of the child.

When diagnosing multiple or tight entanglement, as a rule, delivery is carried out by caesarean section. Most often, the operation is planned for 37-38 weeks of pregnancy. Although such surgical intervention is not excluded at an earlier date, especially if the doctors consider the baby’s condition to be threatening.

Preventive measures that can eliminate or at least reduce the risk of developing a dangerous pathology directly depend on the causes that affect the occurrence of entanglement of the fetus with the umbilical cord.

First of all, a woman carrying a child should monitor her regimen. Outdoor walks, moderate physical activity, a normal psychological and emotional state, as well as good nutrition, these are the measures that contribute to the normal development of the fetus, which means they prevent many unwanted pathologies, including entanglement with an umbilical cord.

There are special gymnastics that are designed specifically for pregnant women. If there are no contraindications, then a woman should choose the right one for her and exercise regularly. There are also techniques that will teach the expectant mother to breathe correctly. This will allow her body to receive more oxygen, which plays an important role in preventing the occurrence of hypoxia in the fetus, a direct factor that causes entanglement.

A pregnant woman should undergo an examination on time, including a planned ultrasound examination, take the required tests, follow all the instructions of the doctor leading the pregnancy. If entanglement with the umbilical cord is a pathology from the category of hereditary, then in such cases, the future mother is recommended to monitor her well-being more carefully. A little more often than during a normal pregnancy, visit a doctor and take tests.

In general, direct preventive measures to prevent umbilical cord entanglement of the fetal neck do not exist.

The umbilical cord around the neck of the fetus is one of the most common pathologies in pregnant women. On average, every fifth expectant mother faces this unpleasant, and in some cases even dangerous situation. There is a belief that the entanglement of the umbilical cord around the neck happens due to the fact that a woman during pregnancy dealt with threads: she tied knots, sewed or knitted. Believing this popular belief, many expectant mothers refuse to prepare a dowry for their children. Of course, there is no dependence and cannot be. Rather, on the contrary - needlework has a calming effect and can in no way provoke entanglement of the umbilical cord. The cause of this phenomenon is chronic fetal hypoxia, which can be caused by both the lifestyle of a pregnant woman (rare walks, low physical activity), and various pathologies (iron deficiency anemia). Another cause of entanglement and knots in the umbilical cord, which can be even more dangerous, is a very long umbilical cord. It can be up to a meter long. According to the observations of doctors, more often a long umbilical cord occurs in those women whose mothers and grandmothers also had this feature.

What is dangerous entanglement of the umbilical neck of the fetus? Often this diagnosis is made at the second planned ultrasound (at 20-22 weeks). At this time, you don’t have to worry, the child is still relatively small and can wrap and unwind several times a day. Another thing is if a diagnosis is made of double entanglement of the umbilical cord (three times, multiple) around the neck later than 32 weeks of pregnancy. In this case, the woman is more closely monitored. In addition to standard ultrasound, dopplerography and (or) CTG are performed. If there are signs of acute fetal hypoxia (a woman may feel a sharp increase or, on the contrary, a decrease in fetal activity), pathological changes in the heart rate are diagnosed during the examination, and a cesarean section is performed. But, as a rule, a single entanglement of the neck with the umbilical cord does not bring any problems. And, of course, it does not serve as a reason for delivery by surgery.

During pregnancy and repeated entanglement of the neck with the umbilical cord is usually not dangerous, since being inside the womb, the fetus does not breathe with lungs, oxygen enters the body through the blood. Problems can arise only with a very tight entanglement, as it can interfere with the normal blood supply to the body. In addition, knots of the umbilical cord are dangerous. They can be true or false. For nodes of the umbilical cord on ultrasound, varicose veins on it are often mistaken. These are false nodes that do not carry danger. Exactly which node takes place - false or true, is found out only at the time of the birth of the child. And here, just as if there is an entanglement with the umbilical cord, a lot depends on the experience, actions of the midwife and the doctor taking delivery. Firstly, with such pathologies, contractions cannot be artificially stimulated. Secondly, in the task of honey. workers include an acceleration of the second stage of labor (the period of exile). In most cases, an episiotomy is performed. During childbirth, the doctor and midwife monitor the fetal heart activity very closely using an obstetric stethoscope and/or cardiotocography (CTG). In case of problems in the first stage of labor, an emergency caesarean section is performed. If a woman's cervix is ​​fully open, there are attempts, but weak, the child is pulled out with forceps or other obstetric techniques are resorted to for the speedy birth of him. It is the task of the midwife to carefully remove the loops at the birth of a child if the umbilical cord is seen to be wrapped around the neck.

Undoubtedly, such pathologies need increased attention from gynecologists and the expectant mother herself to her own condition and motor activity of the child. But in most cases, everything ends safely with the birth of a healthy child. Although there are difficult situations in which a professional medical approach is required. It never hurts to play it safe and consult with several experts.

Prevention of various pathologies of the umbilical cord is regular testing (and especially a blood test - for the early detection of iron deficiency anemia and the start of taking drugs to compensate for the lack of iron in the body), following all reasonable doctor's recommendations. A correct lifestyle is recommended - daily walks in the fresh air with good health and less worries. Try not to quarrel with anyone, being in an interesting position, do not watch dramas, thrillers, horrors on TV, because with any anxiety, the hormone adrenaline is formed in the body, which enters the child’s body through the bloodstream and has an exciting effect on him: the baby’s motor activity, and it can become entangled in the umbilical cord.

When a pregnant woman hears from a doctor that her baby has an umbilical cord entanglement, it sounds ominous. And if this pathology is located around the neck, there are fears for the baby. But is the devil as terrible as he is painted? What is the danger of entanglement, how to determine it and, most importantly, how to act for a future mother when making such a diagnosis, we will consider in more detail.

The umbilical cord and its functions

Until the third trimester, the fetus moves quietly in the uterus and can both become entangled and unravel from the umbilical cord

The umbilical cord is a special organ that forms during pregnancy and connects the mother's body with the child. It is through the umbilical cord that the baby receives the nutrients and oxygen necessary for life and development.

At one end, the umbilical cord is attached to the abdominal wall of the fetus, after birth it will be cut off to form the navel we are used to, and at the other end to the placenta. The average length of the umbilical cord is 50-60 cm. The umbilical cord is considered long if its length reaches 70-80 cm, and short if the length is less than 40 cm. A long umbilical cord increases the risk of entanglement.

The umbilical cord performs the following functions:

  • delivery of oxygen;
  • supply of nutrients from mother to child;
  • excretion of waste products from the body of the baby.

What is cord entanglement, causes and types

An entanglement is a condition when the umbilical cord creates a loop around any part of the baby's body. The nodule may form around the trunk, neck, or limbs of the fetus. Multiple entanglement, when several parts of the baby’s body are captured by the loops of the umbilical cord, does not go away on its own and requires close supervision of doctors

I want to immediately reassure expectant mothers: on average, every fifth birth occurs when the baby is entwined with the umbilical cord, and this is far from always the cause of any negative manifestations.

In vain is the fear about the entanglement of the umbilical cord around the baby's neck. The fact is that the fetus in the womb does not breathe with lungs, so entanglement is dangerous only in terms of the fact that the umbilical cord itself can be squeezed. The very same squeezing the neck does not cause any harm to the baby.

Causes of entanglement of the fetus with the umbilical cord

Although not a single mother carrying a baby in the womb is immune from entanglement with the umbilical cord, there are a number of reasons that provoke this pathology:

  • long umbilical cord (70–80 cm);
  • increased activity of the baby due to hypoxia;
  • polyhydramnios;
  • the presence in the mother's diet of tonic drinks - tea, coffee;
  • an increase in movements due to adrenaline, a substance released into the blood of a future mother during stress.

In this vein, of particular importance is the long-standing advice to pregnant women - "less nervous." Especially in the case of diagnosed polyhydramnios or an elongated umbilical cord.

Types of entanglement

By the number of loops, the entanglement is divided into the following categories:

  • single;
  • double;
  • triple.

According to the degree of tension, the entanglement is divided into the following types:

  • tight;
  • not tight.

According to the features of the parts of the body captured by the umbilical cord, the entanglement is divided into the following categories:

  • isolated - in the case when only the neck or one other part of the body is wrapped with the umbilical cord;
  • combined - when the nodes simultaneously cover several parts of the baby's body.

The safest is a single isolated, non-tight entanglement. The author of this article was also diagnosed with this type of pathology during pregnancy. At the same time, specialists from both ultrasound and the antenatal clinic, and later the maternity hospital, did not see any danger in this and did not prescribe any measures like a protective regimen or sedatives. The doctor chosen for the delivery, reassured: a single loose entanglement is not an indication for a caesarean section. During natural childbirth, as soon as the baby's head appears, the doctor carefully removes the umbilical cord from the neck and thus the problem is solved quickly and easily. In the case of an emergency, as happened in the case of the author, or a planned (for other reasons) caesarean section, the removal of the umbilical cord loop is even easier, since in this case the child does not pass through the birth canal and there is no danger of tension on the umbilical cord.

Symptoms and diagnosis of cord entanglement

The only symptom of cord entanglement is an increase in fetal activity. If a woman feels an unusually large number of movements of the child, as well as in the case when the tremors become sharper, this is an occasion to immediately visit the doctor who leads the pregnancy. Since the first phase of hypoxia has come. The specialist will prescribe all the necessary examinations to identify the cause of increased activity.

Emergency measures require a state of "calm", when after a long, up to several days, increase in activity, the movement stops. A sharp slowdown means that the second, dangerous for the life of the fetus, phase of hypoxia has come. The baby's strength is over and he can no longer give signals to his mother. In this case, it is necessary to call an ambulance and go to the hospital, where, with a high degree of probability, the woman will be placed to maintain the pregnancy. In severe cases, if the time permits, the doctor may decide to perform an emergency caesarean section to save the life of the child.

To determine the entanglement of the umbilical cord and assess how dangerous it is for the fetus, the following examinations are performed: ultrasound, CTG, dopplerometry.

Ultrasound procedure


 Ultrasound diagnostics allows you to establish the fact of entanglement with the umbilical cord and assess the general condition of the fetus

Ultrasound diagnostics is a modern, safe for the fetus method of analyzing the condition of the baby. Ultrasound, unlike, for example, x-rays, can be done as often as the situation requires - even if you have to carry out this type of diagnosis several times a week.

Thanks to ultrasound, the doctor will be able to draw the following conclusions:

  • will determine the very presence of entanglement;
  • evaluate the general condition of the fetus;
  • check the condition of the umbilical cord and amniotic fluid.
  1. Sometimes during an ultrasound scan it is impossible to examine the child because of its inconvenient position for the apparatus. In this case, you need to go out and walk for 10-15 minutes along the corridor or on the street, weather permitting. The movement of the mother will allow the baby to change position, and then the diagnosis will be effective, without the need to come additionally.
  2. It is highly desirable to come to the ultrasound in a calm state, even if you are almost sure that there is an entanglement. Since stress will lead to increased activity of the child, which will complicate diagnosis and may lead to the production of the so-called "false entanglement". This false diagnosis is made when, with a complication of diagnosis, the device shows a loop that seems to be wrapped around the fetus, but in fact is nearby.

Cardiotocogram


 Cardiotocogram - the most reliable way to assess the prenatal state of the fetus

CTG (cardiotocogram) - a study of the fetal heart rate, its changes depending on the movements of the baby. Today, CTG is the most informative method for analyzing a baby in the womb.

CTG is measured with a special ultrasonic sensor, which is fixed on the belly of a pregnant woman.

This study is carried out no earlier than 32 weeks of pregnancy, when the sleep and wakefulness of the fetus is established.

The main condition for a correct result, which is rarely warned by doctors, who, as a rule, have a tight schedule, is that the child must be awake at the time of the CTG. Otherwise, the data may give false positive or false negative information about the condition of the fetus.

It is important to understand that the conclusion on the interpretation of the CTG recording is not a diagnosis. The results of a single study give only an indirect idea of ​​the condition of the fetus from the moment of the study for no more than a day. They should be considered only in conjunction with the clinical picture, the nature of the course of pregnancy and other studies - ultrasound and Doppler.

AND ABOUT. Makarov, Doctor of Medical Sciences, Professor

https://www.medison.ru/si/art239.htm


 For correct results, dopplerometry should be carried out during the rest period of the baby.

Dopplerometry studies the features of blood flow in the child's place, the arteries of the baby's brain, as well as in the umbilical cord.

Doppler is also performed using ultrasound. The optimal start date for the study is the 30th week, but if indicated, it can be prescribed earlier - starting from the 20th week of pregnancy.

Doppler ultrasound is performed on ultrasound machines, for the patient the procedure does not differ from conventional ultrasound diagnostics: the specialist drives the sensor over the abdomen, following the results on the monitor screen. Only unlike conventional ultrasound, the doctor sees curved blood flow lines, based on the speed of which a conclusion is made about the condition of the fetus.

To obtain the correct results, dopplerometry must be carried out during the rest of the baby. Otherwise, the device will give false values, which can have detrimental consequences for the fetus.

Video: Ultrasound diagnosis of entanglement of the fetus with the umbilical cord

Risks and consequences of cord entanglement

As already mentioned above, the entanglement may not pose a danger to the child and not affect the delivery process. But in any case, the woman is under closer supervision of doctors, since the entanglement carries certain risks:

  • narrowing of the vascular lumen, leading to a lack of oxygen and nutrients for the child;
  • premature detachment of the placenta during childbirth;
  • incorrect insertion of the baby's head to pass through the birth canal.

From the risks follow possible ways to remove the entanglement of the baby's umbilical cord. So, with a narrowing of the lumen, the doctor may decide on a planned cesarean section, usually this happens after the 37th week of pregnancy. But the operation can be performed earlier if there is a deterioration in the condition of the baby.

According to a scientific study conducted in 2015, which involved 102 women who gave birth urgently due to progressive fetal hypoxia, it was revealed that caesarean section reduces the incidence of lesions of the central nervous system, as well as developmental delays in children exposed to intrauterine hypoxia.

If the woman’s labor activity has already begun and detachment of the child’s place has come or the fetus has been inserted incorrectly, an emergency caesarean section will be performed in order to save the life and health of the child. At such a moment, the patient's trust in her doctor is important. Today there are many opponents of caesarean section and supporters of natural childbirth. But it is important to remember: the harm caused to the child by hypoxia far exceeds the risk of complications of operative delivery.

So, the entanglement that led to the clamping of the umbilical cord can have the following consequences:

  • deterioration of blood supply in the transferred part of the body and, as a result, underdevelopment or possible incorrect functioning in the future;
  • low weight of the fetus;
  • insufficient development of organs and systems of the child due to a deficiency of nutrients;
  • hemorrhages in vital organs;
  • disorders of the central nervous system due to hypoxia up to disability.

Video: fetal hypoxia with cord entanglement

Treatment and actions of the expectant mother in diagnosing cord entanglement

There is no such treatment for this condition. A pregnant woman is shown more frequent visits to the doctor with additional examinations. Perhaps a woman will be prescribed a complex of drugs that support uteroplacental blood flow.

Sometimes there is a need for hospitalization: if the examination specialist detects acute hypoxia or uteroplacental insufficiency.

Also, if there is an entanglement, the expectant mother is recommended to undergo CTG at least once a week. Moreover, it is often necessary for the pregnant woman herself to monitor this. During the “interesting situation”, the ultrasound specialist also strongly recommended to the author to do CTG every week, but in the antenatal clinic, no action was taken on this recommendation - the author herself had to ask for additional numbers for CTG. Thus, despite the fact that a pregnant woman is observed by professional doctors, you should always remember: the responsibility for the baby lies primarily with her.

Childbirth during entanglement

With a single loose entanglement, natural childbirth is possible. At the moment when the baby's head appears, the midwife will carefully remove the noose and thus solve the problem. At the time of the release of the child, the woman in labor is forbidden to push. The doctor will definitely tell the woman in labor about this. Therefore, it is so important during childbirth to listen to the commands of doctors and immediately follow them.
Even a double entanglement, if it is not tight, can be removed by a midwife at the time of birth of the baby's head.

A planned caesarean section will most likely be prescribed in case of tight multiple entanglement around the fetal neck.

An emergency caesarean section will be performed if hypoxia is detected in the child.

During labor, the following examinations are carried out:

  • fetal heart rate control: in the first stage of labor - every 15-20 minutes; in the second period, with the onset of attempts - every 3 minutes;
  • CTG: performed every 3 hours for 20-30 minutes, longer if necessary, or throughout the entire period of labor.

If examinations show a deterioration in the situation, the doctor may decide to speed up labor or, if acute hypoxia is detected, to perform an emergency caesarean section.

The free part of the umbilical cord shortened due to entanglement may prevent the baby from moving along the birth canal, in such cases the obstetrician cuts the perineum - an episiotomy, so that the child can continue moving along the birth canal.

If the sensors show that hypoxia has set in, the doctor may use vacuum extraction or obstetric forceps to speed up the extraction of the fetus. Unfortunately, both methods of childbirth are very dangerous for the fetus. According to a study conducted on the basis of 75 women who gave birth with vacuum extraction, and 565 women who used obstetric forceps during childbirth, from 27.2% to 80% of children born in such ways, there are severe damage to the nervous system, trauma to the head and spinal cord.
Vacuum extraction and obstetric forceps are used if the entanglement has led to acute fetal hypoxia

That is why prenatal examination and birth monitoring of the condition of the woman and the fetus is of particular importance. This allows you to carry out an emergency caesarean section and not bring the situation to the need for extraction.

Prevention of entanglement of the umbilical cord of the fetus


 Slow walks during pregnancy are an effective means of plastically entwining the baby with the umbilical cord

Preventive measures include the following activities.

Umbilical cord entanglement: consequences, causes - today the focus of the site for mothers is the site. Indeed, according to statistics, this is possible in 20% of cases.

Too active behavior of the baby in the womb can lead to the fact that he simply "gets entangled" in the loops of the umbilical cord, and they wrap around the neck or other parts of the body several times. In some cases, the child himself gets out of the umbilical cord, but there are also situations when you can’t do without the help of a doctor.

This pathology appears quite often. In the last stages of pregnancy, an obstetrician-gynecologist can tell the expectant mother such unpleasant news.

In addition, the reasons for this phenomenon, although they lie in the excessive activity of the child, are associated with the health of the mother and her behavior.

Cord entanglement: causes and consequences

If you believe the signs, then during pregnancy you should not knit, sew, weave anything, actively engage in gymnastic exercises. But there is no scientific evidence for this, so each decides for herself what to do, whether to believe the speculations of her ancestors.

It is better to look at the problem from a medical point of view. Obstetricians and gynecologists identify the following reasons:

  • fetal hypoxia,
  • improper lifestyle during pregnancy - frequent stress, constant overwork of the mother,
  • unbalanced diet,
  • too long umbilical cord (over 70 cm).

By the way, the hyperactivity of the baby in the womb is not at all his fault. Perhaps it becomes so mobile in search of oxygen and nutrients. This happens when the expectant mother drinks too much black tea and coffee, drinks alcohol or smokes.

In addition, due to constant stress in the blood, the concentration of adrenaline increases. This also affects the nervous excitability of the child.

Features of the birth process

If umbilical cord entanglement is detected, specialists may prescribe dopplerometry. This procedure will allow you to study and monitor the intensity of blood flow through the vessels.

It is also important to make an appointment for cardiotocography to detect the fetal heart rate. Doctors will understand if there is a lack of oxygen.

If the child has 1-fold entanglement with the umbilical cord, natural childbirth is possible. But with a double appointment.

If you insist on another option for delivery, the consequences can be severe - asphyxia, death of the child. Moreover, if doctors diagnosed a double entanglement at 38 weeks, they can operate during this period without waiting for the end of the 40-week period.

Cord entanglement around the neck: consequences

A single entanglement usually resolves safely. Either before childbirth, the baby spontaneously gets out of the loop, or in the process of childbirth it is released from it, and everything ends without complications.

Double cord entanglement: consequences

With a double or multiple tight entanglement of the umbilical cord, there is a serious danger. This phenomenon can cause hypoxia. And because of the lack of oxygen in fetal development, violations occur. The baby's body as a whole ceases to function normally.

There are changes in metabolic processes, adaptive capabilities are reduced, damage to the central nervous system occurs. The longer the oxygen deficiency, the more pronounced the consequences will be.

Squeezing the umbilical cord of the neck or limbs can cause disturbances in the blood supply to the tissues. Due to the strong tension of the umbilical cords, early abruption of the placenta or childbirth may occur much earlier than the term.

A strong multiple entanglement of the fetus with the umbilical cord sometimes even has extremely deplorable consequences. The umbilical cord tenaciously squeezes the baby's neck, like a noose, and in severe cases, intrauterine fetal death occurs.

The entanglement of the umbilical cord is not always fatal, but the site notes that such a phenomenon may not pass without a trace for the child.

Cord entanglement: consequences for the child in the future

Staying in a state where there is not enough oxygen to the baby for a long time can affect the development of the brain. Irreversible processes occur in it, and in the future this leads to a deterioration in physical and mental development.

Psychological consequences of entanglement of the umbilical cord around the neck of the fetus

They do not appear immediately, but after a few years. For example, a child may have tantrums and tears when tying scarves, ties, bow ties. In stressful situations, asthma attacks may disturb.

What to do? As soon as possible, contact specialists who can provide correct psychological assistance.

And do not provoke unpleasant situations. Do not force them to wear turtlenecks and scarves so that the child does not feel discomfort.

Not always the entanglement of the umbilical cord has deplorable consequences, but, as they say, forewarned is forearmed!

“You have an umbilical cord around the neck of the fetus” - these words are often heard by pregnant women during an ultrasound examination. Anxiety immediately begins: is it dangerous? Will the child get hurt? How to give birth?

The umbilical cord as a source of life

The umbilical cord is what connects the little baby with the mother. It delivers to the fetus all the necessary elements and substances, as well as oxygen.

Some interesting facts:

  • Completes its formation in the second trimester of pregnancy, by about 15 weeks of development;
  • The average length is normal - 40-61 cm. Thickness - up to two cm;
  • Studies have shown that the length of the umbilical cord is a hereditary phenomenon;

The main purpose of this "rope" is the delivery of oxygen to the fetus.

Tangled in the umbilical cord - why?

The entanglement of the umbilical cord around the neck is not uncommon in gynecological and obstetric practice. The main reason is the anomalous length of the main conductor of life - more than 70 cm. The fetus in the womb makes unconscious movements, so in this "situation" the chance that it will loop around is quite large.

There are several factors that increase the risk of umbilical cord entanglement around the baby's neck:

  • Fetal hypoxia. Due to the lack of oxygen, the baby begins to actively move;
  • Violation of blood flow;
  • The presence of polyhydramnios;
  • Breech or transverse presentation;
  • Chronic nervous tension in a pregnant woman. The chain is as follows: stress - the release of adrenaline - the penetration of the hormone through the placenta to the child - an increase in activity;

The unhealthy lifestyle of the expectant mother affects the entanglement of the umbilical cord around the neck. If she walks a little in the fresh air, eats poorly or smokes, then hypoxia in the baby will be a natural consequence.

Problem Diagnosis

The main method for detecting various pathologies of pregnancy is ultrasound. It will help to identify not only a single, but also a double entanglement of the umbilical cord, and even a triple one.

Additional studies are CTG and Doppler. It is important for doctors to understand whether this loop is dangerous and the condition of the fetus in this pathology. If there is a violation of blood flow, severe oxygen starvation, and CTG shows a slowdown in heart rate, then the woman is prescribed special drugs and supportive therapy.

It is believed that before the 34th week of pregnancy, the baby can unravel itself.

Most often, a double entanglement around the neck with the umbilical cord is diagnosed, but it happens that the baby gets tangled with the whole body, and also the legs or arms are “captured”.

Consequences of cervical entanglement with the umbilical cord

Suspicious mothers should calm down: in most cases, the entanglement does not pose any danger. With this diagnosis, they do not put them in a hospital and do not treat them in any way. Just watch a little more carefully. Only a tight loop, or the presence of a violation of blood flow, alarms specialists. This can lead to a severe lack of oxygen.

Rarely, excessive compression of the umbilical cord vessels and, as a result, placental abruption occurs.

Indications for delivery by caesarean section:

  • Too tight and repeated entanglement of the umbilical cord around the neck of the fetus;
  • The absence of loose loops, which will not allow the child to be born naturally;
  • CTG shows that the blood flow is severely disturbed

Which way the baby is destined to be born, the doctor decides. In natural childbirth, specialists constantly monitor the baby's heart rate. If the situation begins to deteriorate rapidly, an emergency caesarean is performed. But usually the midwife simply removes the loops from the neck of the newborn.

Note to pregnant women: do not listen to the advice of "experienced" and try to solve the problem yourself. Folk methods will not help, but only harm. Exercises to stimulate detangling are also futile. The best thing that a future mother can do when umbilical cord entanglement is detected is to stop being nervous, visit the attending gynecologist on time and eat right.