Is triple cord entanglement dangerous? Is the umbilical cord entwined around the fetal neck a real danger or an exaggerated anxiety? How to avoid entanglement of the umbilical cord

02.07.2020

During pregnancy, the baby has a special bond with his mother. At the biological level, this connection is made through the umbilical cord. This article describes in detail whether it is dangerous to entangle the umbilical cord around the neck of the fetus, how it affects childbirth.

What it is?

The umbilical cord is a very important organ that is formed in the body only in a pregnant woman. By outward appearance the umbilical cord resembles a twisted gray-blue cord. The length of the umbilical cord varies. In some cases, it can be quite long, which can contribute to the formation of various pathologies during pregnancy.

One of these pathological conditions is the entanglement of the umbilical cord around the neck of the fetus. In this case, the umbilical cord loops are located directly on the baby's neck.

Umbilical cord entanglement is a diagnosis that can scare every pregnant woman. Many women remember that when doctors diagnosed them during pregnancy, they experienced a real fear for the life of their baby. You can understand such a reaction.

Umbilical cord entanglement around the fetal neck is a rather dangerous pathology that requires careful medical supervision, as well as a search for suitable tactics for managing pregnancy, and in the future - and the right way obstetrics.

Causes of occurrence

The development of the umbilical cord entanglement of the fetus's neck occurs for various reasons. Doctors identify several reasons that can lead to the development of this pathology during pregnancy:

Genetics. The looping of the umbilical cord around the baby's neck may be due to genetic factors. Some scientists believe that the length of the umbilical cord is a hereditary factor. The average length of the umbilical cord is approximately 40-60 cm. In some cases, it is lengthened (up to 75-80 cm or more). In such a situation, the risk of entanglement formation is quite high.
Stress and traumatic influences. Scientists have identified interesting fact: pregnant women, who are often nervous and worried for various reasons during pregnancy, have a rather high risk of developing this pathology. They believe that the cause is an increase during stressful effects of the level of certain hormones, one of which is adrenaline.

A change in the amount of hormones in the blood can enhance the motor activity of the fetus, as well as lead to certain functional disorders. In some cases, this contributes to the entanglement of the umbilical cord around the baby's neck.

Change in the amount of amniotic fluid. For existence and full intrauterine development the child needs an aquatic environment. If there is enough amniotic fluid, the baby is doing well. At the same time, nothing interferes with his motor activity. If, for some reason, the amniotic fluid in the uterus becomes larger, this can contribute to the formation of a number of pathologies. One of them is twisting the umbilical cord loops around the baby's neck.

Environmental factors. Some scholars believe that climatic conditions can also cause the umbilical cord to be entwined around the baby's neck during intrauterine development. The researchers note that a sharp change in climate can lead to the formation of this pathology during pregnancy. A change in climatic conditions during pregnancy most often contributes to the development of this pathology in women who suffer from any chronic diseases. During pregnancy, moving to another city, where the climatic conditions are significantly different, the body of the expectant mother perceives as severe stress. In such a situation, the risk of the umbilical cord entwining the fetus's neck is also significantly increased.

It is believed that overheating and hypothermia of the body of a pregnant woman are factors that can contribute to this.

Smoking... Some doctors note that umbilical cord entanglement occurs more often in women who smoke. This can be facilitated by the entry into the bloodstream of nicotine and other chemicals that are contained in cigarettes in a large number... They have an adverse effect on the intrauterine development of the baby, contribute to the occurrence of various diseases.
Alcohol... One more bad habit, which can lead to entanglement of the umbilical cord, is the use of alcoholic beverages. The ethyl alcohol they contain has a negative effect on the blood vessels in the umbilical cord. Such an impact leads to the occurrence of various disorders in the fetus, including it is a possible factor in the development of the twisting of the umbilical cord around the baby's neck.

Intense sports... Obstetricians-gynecologists note that active physical exercises can also lead to entanglement. Expectant mothers who have a long umbilical cord and some other features during pregnancy should be extremely careful while playing sports. Possibility of visiting gym or swimming pool in such a situation, be sure to discuss with your doctor. In some cases, the umbilical cord entanglement of the baby's neck can be a contraindication for sports and fitness.

Doctors recommend that expectant mothers, who have entanglement, spend more time in the fresh air. At the same time, it is better to walk at a moderate pace. To improve overall well-being, special breathing exercises... They can be performed throughout the entire period of pregnancy.

How could it be?

Umbilical cord loops can be wrapped around the fetus's neck in different ways. Doctors identify several clinical variants of this pathology. It all depends on how many times the umbilical cord loops are wrapped around the baby's neck. Doctors distinguish one-, two- and three-fold entanglement.

If, for some reason, the umbilical cord is wrapped in its loops more than three times, then such an entanglement can be considered multiple. Each of the clinical variants has its own specific developmental characteristics.

One-time

With this variant of the pathology, the umbilical cord loop is wrapped around the child's neck only once. This variant of the pathology occurs in 20-25% of pregnant women. Usually, expectant mothers are faced with a loose entanglement. This means that the loop of the umbilical cord is not tightly wrapped around the fetus's neck and does not squeeze it. Forecast further development pregnancy with this variant of the pathology is most favorable.

A tight single entanglement is considered less favorable. In this case, the loop of the umbilical cord located around the neck can lead to squeezing. cervical spine. In such a situation, the child may experience very dangerous complications.

Double

With this variant of the pathology, the umbilical cord loops are wrapped around the neck of the fetus 2 times. Doctors can determine this pathology at different dates pregnancy. If detected early, the prognosis is usually quite good. If there is a sufficient amount of amniotic fluid in the uterus, and the fetal motor activity is not disturbed, it can still "unravel" before the onset of labor.

If doctors determine that the umbilical cord is twisted twice around the fetus's neck after 37-38 weeks of pregnancy, as a rule, this condition remains until the very birth. By this time, the baby is already quite large and moves much less. This is due to the fact that every day, as the birth approaches, it becomes more and more "cramped" in the uterus.

Triple

A favorable prognosis for the development of this pathology can be in the event that the loops of the umbilical cord do not squeeze each other very strongly. If they tightly squeeze each other, then in such a situation the child may develop intrauterine hypoxia. In this case, urgent medical intervention is required and the choice of the correct tactics for the further management of pregnancy.

How to suspect?

Unfortunately, there are no direct clinical signs that would indicate the presence of this pathology during pregnancy. It is possible to suspect the presence of the umbilical cord entanglement with the fetus's neck only if certain complications of the course of pregnancy are already beginning to appear. In most cases, this pathology is detected by chance - during a routine ultrasound examination.

If the expectant mother is diagnosed with an umbilical cord entanglement around the fetus's neck, then she should be careful enough in relation to her general condition, as well as the well-being of her baby. One of the signs that may indicate that the baby is experiencing discomfort in the mother's womb is a change in his motor activity. This is especially evident in the fetus after 28-31 weeks of gestation. By this time, the baby has already formed a circadian (diurnal) rhythm. This contributes to the fact that the child, as a rule, is more active in daytime days, and usually rests at night.

If the expectant mother began to notice that her baby began to move much less or is too “active” at night, then she should definitely show herself to her obstetrician-gynecologist.

The doctor will conduct the necessary examination, thanks to which it will be clear how the baby is feeling, whether any complications of the pregnancy have developed.

Diagnostics

The basic diagnostic method that allows you to identify this pathology is ultrasound. Before the advent of ultrasound techniques, doctors could not determine entanglement. This often contributed to the fact that a pregnant woman with this pathology experienced certain complications during natural childbirth. Currently, ultrasound specialists can quite successfully detect signs of the umbilical cord entanglement with the fetal neck.

Ultrasound examination is the basic, but not the only study that is carried out when establishing the diagnosis of entanglement. To assess the condition of the fetus, doctors must also resort to other diagnostic tests. One of them is a Doppler study.

By conducting it, you can assess the blood flow through the vessels that are in the umbilical cord. This allows doctors to exclude dangerous complications of the course of pregnancy, including identifying intrauterine hypoxia. To assess the dynamics of the well-being of the baby in the mother's womb, doctors can perform Doppler ultrasonography several times. This allows them to track any possible pathologies and complications that may arise before childbirth.

Another diagnostic method that allows you to assess the general condition of the fetus is cardiotocography. This simple and painless method allows doctors to determine the functioning of the child's heart, as well as his physical activity. If everything is normal, no significant changes in these indicators occur. If the baby develops intrauterine hypoxia, this can be indirectly determined on the cardiotocogram.

The undoubted advantage of this method is the possibility of its repeated implementation. For a mother-to-be who has been diagnosed with an umbilical cord entanglement, cardiotocography may be prescribed several times before the onset of labor. Such dynamic observation allows doctors to timely identify dangerous complications and, if necessary, change the tactics of pregnancy management.

Consequences for the fetus

In order to understand what the danger of the development of various complications in this pathology lies in, one should touch a little on some biological features. It is important to remember that the fetus receives oxygen during intrauterine life not through the trachea and its own respiratory tract, but in a dissolved form through the blood. Oxygen in this situation enters the child's body through the system of blood arteries, which are located in the umbilical cord.

So it becomes clear that the main condition for the normal intrauterine development of the baby and the full supply of oxygen is the location of the loops around the neck with two and multiple entanglements.

If the loops are tightly squeezed, this can lead to strong compression of the blood vessels in the umbilical cord. In such a situation, the fetus does not receive a sufficient amount of dissolved oxygen, which can contribute to the development of intrauterine hypoxia - oxygen deficiency of all internal organs and tissues.

Prolonged intrauterine hypoxia is an extremely dangerous condition. It contributes to the fact that the child's functioning of all internal organs is disrupted, including the vital ones - the heart and brain. In such a situation, the fetus may develop certain pathologies (and even developmental anomalies).

Intrauterine hypoxia can lead to early onset of labor. In such a situation, the baby can be born much earlier. due date... In this case, the baby may be premature, and his lungs will not be ready for spontaneous breathing.

Strong compression of the blood vessels that are inside the umbilical cord can also lead to a violation of the blood supply to the placenta. In such a situation, the functioning of the placenta is impaired. In some cases, this can even lead to the development of detachment of placental tissue from the uterine wall. This pathology can be extremely dangerous and cause the development of premature birth.

Natural independent childbirth, complicated by the presence of a tight multiple entanglement with the umbilical cord of the fetus's neck, can be dangerous and the occurrence of dangerous injuries and injuries. As a rule, in this case, the child has various injuries of the cervical spine. The severity of these injuries varies. To prevent this, doctors still try to resort to performing a caesarean section.

Remember that every pregnancy is unique. Doctors can only predict the development of certain complications. Birth healthy baby in the presence of an elongated umbilical cord depends on many factors. In one case, a healthy baby is born, and in the other, a child who has some pathologies during childbirth.

Features of labor management

The choice of obstetric tactics largely depends on how tightly the umbilical cord is wrapped around the baby's neck. With a single entanglement, doctors can also allow natural childbirth. In this case, during labor, the obstetrician-gynecologist must monitor the appearance of the head. As soon as she is born, the doctor can independently remove the umbilical cord loop from the neck. In this case natural process childbirth is usually not disturbed.

When detecting a double entanglement of the umbilical cord with the fetus's neck a few weeks before pregnancy, doctors, as a rule, choose a surgical method of obstetrics. In such a situation, natural childbirth can be very dangerous. During labor, the umbilical cord loops can severely squeeze the baby's neck, which will lead to the development of dangerous complications (and even, possibly, birth injuries).

When the umbilical cord is entwined three times around the fetus's neck, doctors often resort to performing a caesarean section. The surgical method of obstetrics is also used in cases where there are other features of the course of pregnancy.

For information on how to fix the umbilical cord entanglement around the fetus's neck, see the next video.

Umbilical cord entanglement around the fetal neck, cord knots, hypoxia - what is the reason?

During pregnancy, the umbilical cord is formed simultaneously with the placenta and serves to connect the mother and the fetus - oxygen and nutrients enter the developing child through two arteries, and waste products leave it through the vein. Normally, the length of the umbilical cord is from 40 to 60 cm with a thickness of 2 cm.

Causes of the umbilical cord entanglement around the neck of the fetus

As the fetus moves inside the fetal bladder, it can twist and fall into the knot formed by the umbilical cord - more often it wraps around the neck, sometimes around the arms and legs. Umbilical cord nodes are divided into true (rare, in 2-3% of cases) and false (in all other cases). False nodules are lump-like varicose enlargements of the umbilical cord or its folds, which look like knots on ultrasound. You can study the umbilical cord by ultrasound from the 17th week of pregnancy.

Why does the umbilical cord entanglement occur during pregnancy? Even very young people, probably, have heard about the old beliefs that a pregnant woman cannot knit and weave anything - it is from this that the umbilical cord is entwined around the neck of the fetus. Of course, this is nonsense. During pregnancy, the movements of the fetus in the uterus are sometimes very intense. It is then that he can slip his head into the loop of the umbilical cord, and the umbilical cord will entwine around the fetus's neck. The likelihood of this is small, and therefore true loops are rare.

Dangerous are double or multiple entanglement of the umbilical cord around the neck of the fetus. A single shot is not considered a pathology at all. Strengthening of movements, their intensity may indicate the excitement of the mother or hypoxia, i.e. lack of oxygen, this is the reason for the appearance of loops and entanglement with the umbilical cord.

Since the baby does not breathe with his lungs before birth, slight compression on the neck will not harm the fetus before delivery. The danger is possible only at the moment of birth. Therefore, even when diagnosing a true node or double entanglement with an umbilical cord, and this can be done using not only ultrasound, but also Doppler, doctors use expectant tactics. The fetal heartbeats are monitored, and if the fetus does not have hypoxia, labor is not accelerated. Double or more entanglement of the umbilical cord around the neck is an indication for delivery by surgery at a period of 37 weeks, and in case of a violation of the condition of the fetus - even earlier.

In other cases, a woman gives birth herself, and the diagnosis of an umbilical cord entanglement around the neck is not made as long as the fetal bladder is intact - after all, the child can unwind itself in the same way as it spun. At the same time, the child's condition is monitored carefully so that at the first signs of fetal suffering, the delivery can be accelerated - perhaps, labor stimulation will be needed, perhaps at the beginning of the process, and an operation. When the head appears from the birth canal, the loops of the umbilical cord twisted around the neck are removed - and nothing is scary!

In this way, prevention of an umbilical cord entanglement around the fetal neck simple. Adequate exposure to the air is necessary, the exclusion of smoking and being in a stuffy room, less excitement and more festivities for the expectant mother. And you can safely wait for the birth, the cord entanglement is no longer so frightening.

This condition, detected by ultrasound, is diagnosed in every third pregnant woman. If it became known about the entanglement on early dates, then there is no reason for excitement yet. At this time, the fetus is still very small, it has a lot of room for active movements. He floats, rolls over. And sometimes, several times a week, it first falls into the loop from the umbilical cord, and then just as easily gets released from this loop. Measures should be taken if the entanglement is found closer to childbirth, when the child has already taken its final position before birth.

Question 2. Why does the entanglement of the umbilical cord occur?

The umbilical cord is a special organ that connects the placenta to the fetus. The formation of the umbilical cord begins at 11 weeks. By the time of delivery, its thickness reaches 2 cm: at this time, it consists of two arteries and one vein. The arteries carry the fetal blood to the placenta, saturated with carbon dioxide and metabolic products. And through a vein, blood, enriched with oxygen and nutrients, enters the child. The vessels of the umbilical cord are surrounded by a special substance - warton jelly. This jelly-like substance prevents them from being squeezed.

Normally, the length of the umbilical cord is from 40 to 70 centimeters. If it is longer, then in late pregnancy, loops of the umbilical cord can form, into which the head, arm, leg of the child or his torso can fall. The size of the umbilical cord does not depend in any way on the external conditions or the woman's lifestyle. This is a hereditary factor.

Another factor that increases is polyhydramnios. V large volume amniotic fluid, the fetus continues to move actively in later stages. Polyhydramnios is a complication of pregnancy. To identify its causes, you need to consult a gynecologist.

Some babies are even more active in utero than others, and this increases the risk. Often, mobility is associated with the characteristics of the child's character, which are manifested even before childbirth. But it happens that it is due to chronic hypoxia (oxygen starvation of the fetus). When there is not enough oxygen, the fetus begins to worry. The stress hormone cortisol is produced in his body. The heart begins to contract more often in order to saturate the entire body with a small amount of oxygen. Against this background, motor activity increases and, as a result, the risk of entanglement of the umbilical cord.

One of the main reasons for insufficient oxygen supply to the fetus is smoking during pregnancy. Under the influence of nicotine, blood vessels narrow, normal blood circulation is disrupted. This happens not only in the mother's body, but also in the fetus's body, since nicotine easily passes through the placental barrier. Smoking increases the risk of many complications, fetal hypoxia is just one of them.

Hypoxia is often provoked by the wrong lifestyle of the expectant mother, violation of the regime, physical inactivity. For a child to have enough oxygen, a woman must receive enough oxygen herself. It is necessary to ventilate the room, walk in the fresh air, move. Of course, we are not talking about serious physical activity, but special exercises, swimming and walking at a calm pace will only benefit.

Hypoxia of the fetus may occur due to the nervousness of the expectant mother. When a woman is worried, stress hormones are released into her bloodstream: adrenaline and cortisol. They pass the placental barrier and get to the fetus, as a result, the baby begins to move more than it should.

Fetoplacental insufficiency can also be the cause of hypoxia. It is provoked by hypertension, blood diseases, including thrombophilia, and diabetes and kidney disease. Preeclampsia (gestosis) and intrauterine infections are also dangerous.

Question 3. What types of entanglement are there?

The most common and safest case is a single, loose entanglement. Although it happens that the umbilical cord has formed not one, but two or even three loops around the fetus. To find out exactly what kind of entanglement you have to deal with in each specific case, one ultrasound is not enough. A woman is prescribed color Doppler imaging (do not confuse it with Doppler). This technique allows you to see the direction of blood flow in large vessels and, from this data, determine exactly how many loops the umbilical cord has formed. In some cases, it is also required to conduct a three-dimensional echographic study.

Question 4. Can the fetus suffocate if the umbilical cord wraps around the baby's throat?

The fetus cannot suffocate either during intrauterine development or during childbirth. The lungs begin to work only after the baby is born and his oral cavity is free of mucus. Until this moment, the respiratory tract is not involved in providing the baby with oxygen. Therefore, it is not so important whether the umbilical cord wrapped around the throat, arm, leg or torso. Important . It is through her, and during intrauterine development, and during the birth itself, the fetus receives oxygen and nutrients. As long as the blood flow in the umbilical cord is not disturbed, the child does not suffer, even if his throat is entwined. A dangerous condition is when the lumen of its vessels narrows from tension or clamping of the umbilical cord. In this case, the fetus experiences a lack of oxygen - hypoxia.

Question 5. Does entanglement affect the intrauterine development of the fetus?

To understand if there is a threat, cardiotocography (CTG) is prescribed. During this study, using an ultrasound sensor, the fetal heartbeat, its movement, and also the contraction of the uterus are recorded. The study is carried out for all expectant mothers, starting from 33 weeks of pregnancy. If, during movements, the number of heartbeats decreases, then there is a danger to the child's health. In this case, doppler ultrasound is also done. It makes it possible to assess the nature and speed of blood flow in the vessels of the placenta and umbilical cord: if these indicators are normal, then everything is in order, and the pregnant woman only needs to accurately follow all the doctor's prescriptions. Usually, when entwining, dynamic observation is prescribed. This is necessary in order to suspect violations in the baby's condition in time and take the necessary measures as soon as possible. Research can be carried out once every 4-7 days, or it can be done every day: it all depends on the condition of the fetus. If daily observation is required, then the woman is usually offered to go to the pregnancy pathology department.

If the dopplerometry showed abnormalities, this indicates that the child is already experiencing hypoxia. This condition is acute and chronic. Acute hypoxia is an indication for emergency delivery. Simply put, the child needs to be rescued urgently. But this is still a great rarity. Chronic hypoxia is more common. Insufficient oxygen supply can lead to changes in metabolic processes, impaired intrauterine development, and a decrease in the adaptive capabilities of a newborn baby. Particularly sensitive to hypoxia nervous system... The longer the fetus experiences a lack of oxygen, the more pronounced all these complications can be. To eliminate undesirable consequences, doctors can prescribe to a woman drugs that support uteroplacental blood circulation. They are also usually recommended for the prevention of hypoxia.

Question 6. Are there ways to untangle the umbilical cord entanglement while still in the womb?

No medical manipulations will help free the fetus from the loop. And if some "healers" promise to do this by some "folk" methods unknown to medicine, you should not believe them. There are no such methods. The doctor may prescribe exercises related to changing the position of the body of a pregnant woman, such as "Kitty". In the starting position, you need to get on all fours with support on your palms and knees. Keep your head straight. Take a deep breath, tilting your head down, while bending your back up. Slowly return to starting position. Do not hold your breath. The well-known "Bicycle" is also prescribed. Pregnant women need to do it at a leisurely pace. Six or nine "turns" will be enough. One more good exercise done against the wall. Starting position: lying on your back, arms along the body, legs bent at the knees. Raise your legs, rest them against the wall. Then, while inhaling, continuing to rest, spread your legs. On exhalation, slowly return to the starting position. Repeat 4-5 times. The essence of the exercises is that with a change in the position of the body of a pregnant woman, the position of the fetus can also change, and it can independently free itself from the loop. But it's better not to expect a 100% result from them. And do not get upset if it became clear that special exercises did not help. It's much better to just calm down. The less the expectant mother is nervous, the less the child will worry. This means that the risk of tightening the loop will decrease.

Question 7. Is an umbilical cord entanglement an indication for a cesarean section?

A single, loose, in itself, most often does not become an indication for operative delivery. But in this case, the entire period of childbirth requires careful monitoring of the child's condition. In the event of acute hypoxia, an emergency C-section.

During contractions, the baby's heartbeat is monitored using fetal CTG. This allows you to understand how the baby reacts to sharp contractions of the uterus. In the second stage of labor, the risk of hypoxia increases. Therefore, the baby's heart is listened to every 3 minutes and after each attempt with the help of an obstetric stethoscope - in other words, a tube. If your heart rate is abnormal, your doctor may give stimulation to speed up labor. In some cases, episiotomy is also used - dissection of the perineum. If the umbilical cord has wrapped around the throat, then the obstetrician releases it from the loop immediately after the birth of the head of the crumbs. At this moment, you cannot push. The doctor will definitely warn about this.

If the entanglement is tight and the umbilical cord is significantly stretched, the tactics of delivery will be different. In this case, the risk of acute hypoxia in natural childbirth is very high. The reason is that when the child passes the birth canal, the umbilical cord is stretched even more, the lumen of its vessels is significantly narrowed. There is another danger as well. The loop makes the umbilical cord shorter. This length may not be enough to allow the fetus to move freely through the birth canal. There is a threat of premature placental abruption. Normally, it separates from the wall of the uterus after the baby is born. Premature placental abruption is one of the most serious complications of pregnancy and childbirth. This is a very dangerous condition for a child, since it is through the placenta that he receives oxygen until the moment he begins to breathe on his own. To minimize the risks in the event of tight entanglement, a woman is usually offered a planned caesarean section.

Question 8. Is it possible to somehow prevent the entanglement of the umbilical cord?

Quitting smoking (including passive smoking), the correct daily routine, and the absence of stress will help to avoid hypoxia in the fetus, and therefore, to reduce the risk of entanglement of the umbilical cord. The expectant mother needs to register for pregnancy at a medical institution as early as possible, undergo all the necessary examinations on time and follow the doctor's recommendations. It is especially important to be under constant supervision if there is a history of diseases that increase the risk of developing hypoxia.

If a knot has formed ...

Many expectant mothers are interested in whether the condition in which the umbilical cord is tied into a knot is dangerous? Distinguish between true and false knot. What appeared to be a knot during the first ultrasound may actually turn out to be a varicose expansion of one of the vessels or a twisted section of the umbilical cord. There is no threat to the child's health in this. A true knot is very rare. It occurs if the umbilical cord first formed a loop, and then the fetus swam through this loop. There is no way to prevent the formation of a true node, since neither the woman nor the doctor can control all the movements of the fetus. The knot itself is not dangerous unless tightened tight. When tightly tightened, the vessels of the umbilical cord can be pinched. This leads to impaired blood flow and, as a result, to hypoxia in the child. To understand if the node is a threat, the doctor also prescribes a Doppler test.

Do not raise your hands up?

Many women, especially the older generation, are still convinced that entanglement occurs due to the fact that a pregnant woman raises her arms high, for example, when hanging clothes or curtains. From this, the fetus allegedly turns over and becomes entangled in the umbilical cord. All this has nothing to do with reality. None modern research did not confirm that raising arms is somehow harmful to the child. This pose is completely natural and cannot lead to undesirable consequences.

Nature is so laid down that close connection a child with a mother begins in the womb. Through the umbilical cord, the baby receives nutrients, oxygen. Decay products and carbon dioxide are removed through the arteries of the umbilical cord. Sometimes the baby is so active that he literally "gets entangled" in the umbilical cord. And then it forms loops that can wrap around the neck or other parts of the body one or more times. It is important and interesting to know why the umbilical cord entanglement of the fetus occurs, how to avoid this and what to do if the problem has already arisen.

fetus: what is it?

Umbilical cord entanglement is a fairly common pathology that obstetricians-gynecologists diagnose on last dates pregnancy. Often the baby himself “solves” the problem and gets out of the umbilical cord loop, but in some cases the help of an obstetrician is needed. How and why the cord entanglement occurs, every pregnant woman should know the causes of this pathology. In some cases, the onset of pathology is provoked by the future mother, so she is obliged to monitor her health and well-being.

The reasons for the development of pathology

According to statistics, 20% of pregnancies are accompanied by an umbilical cord entwining the baby. It is important for the expectant mother to know the reasons for the umbilical cord entanglement of the fetus and, if possible, avoid exposure to provoking factors. Exists folk signs, which say that you cannot sew, knit, weave or actively engage in gymnastics during pregnancy. Believe it or not is the business of every future mother, but we must remember that these are just fictions of our ancestors.

Doctors obstetricians-gynecologists name the factors that cause the development of the deviation. Umbilical cord entanglement can lead to:

stress and overwork;
polyhydramnios;
inappropriate nutrition of the mother;
long umbilical cord.

When registering with an antenatal clinic and for nine months, doctors identify the risks of developing various pathologies and strictly monitor the state of health of the mother and fetus. If a woman is at risk, then she needs to regularly visit an obstetrician and follow all his prescriptions.

Among other pathologies during pregnancy, one of the most common is the entanglement of the umbilical cord. The causes, provoking factors are well studied and doctors successfully accept such childbirth.

How does the entanglement of the fetus take place?

The most common reason for the cord entanglement is the baby's hyperactivity. The baby may lack oxygen, nutrients and substances, and he actively moves in the womb in “search of food”. If the expectant mother abuses coffee, black tea, alcohol, cigarettes, then the child needs more oxygen, which he tries to get additional. Frequent stress leads to an increase in the level of adrenaline in the blood of both the mother and the baby, which causes the baby to be active.

With polyhydramnios, the child has too much room for movement, so he can easily get tangled in the umbilical cord and even tighten its loops more tightly. A long umbilical cord can also get tangled much more easily and form dangerous loops around the baby's neck and body.

Umbilical cord entanglement around the neck

The most dangerous for the health of the fetus is the entanglement of the umbilical cord around the neck. In this case, during childbirth, the loop can be tightened and lead to dire consequences. Modern medicine reached such a level that this pathology is successfully treated and the child is born absolutely healthy. It is important for expectant mothers to regularly undergo all examinations, carry out ultrasound diagnostics and be under the supervision of a doctor.

Single entanglement with the umbilical cord

The most "simple" is a single entanglement with the umbilical cord - one loop is formed on the child's neck, from which the baby often "gets out" on its own. During childbirth, it is easy to loosen and remove the entanglement once. This type of pathology occurs most often and rarely brings problems to the woman in labor and the child.

Multiple entanglement with the umbilical cord

An entanglement, in which two or more loops are formed on the baby's neck, is called multiple. Most often, doctors fix a double entanglement, but there may be three or even four loops of the umbilical cord. This type of pathology is more difficult to correct for doctors during natural childbirth, therefore, a cesarean section is performed.

Consequences of the umbilical cord entanglement

The entanglement of the umbilical cord around the neck leads to the fact that the fetus often experiences microtrauma of the cervical vertebrae. In the future, a child born with an entanglement is prone to frequent and severe headaches, fatigue, and hypertension. There are also problems with and ensuring the nutrition of the fetus: the clamped umbilical cord conducts less nutrients and worse removes waste carbon dioxide.

Such children are assigned special treatment, which consists in massage, physiotherapy, medication. It is important to seek help from a pediatrician, a neurologist in time and start treatment, then the chances of a full recovery increase.

Entanglement around other parts of the body is less common and is less dangerous to the fetus. More often the legs are entwined, less often the arms of the child. In this case, it is even easier for the baby to get out, therefore, it is rarely possible to fix the entanglement with the umbilical cord on ultrasound diagnostics. The reasons for the hug are the same as those listed above.

The most dangerous is the umbilical cord entanglement around the neck. The consequences of this pathology can remain with the child for life and lead to many serious illnesses: hypertension, migraine, dropsy of the brain, osteochondrosis, mental retardation.

Obstetric care with entanglement

In the overwhelming majority of cases, pregnancy with an entanglement of the umbilical cord ends successfully, and childbirth takes place naturally. Childbirth in such women proceeds without complications, the child and mom feel well and, like others, are discharged home in a few days. The only difference is that during delivery, the mother is under intensive medical supervision using Doppler or ultrasound equipment.

After the birth of the fetal head, the obstetrician manually releases the baby's neck from the umbilical cord loop and labor continues. Only with tight or repeated entanglement already in the process of childbirth or is a cesarean section selected in advance. In some cases, this the only way give birth to a healthy baby and avoid problems in the future.

It is important for a pregnant woman to take care of the health of her unborn child. It will be useful for the expectant mother to know how the cord entanglement occurs, the causes and consequences of this pathology. It doesn't matter how the delivery went. It is important that the child is born healthy, and that the mother has the strength to take care of the newborn.

Umbilical cord entanglement around the neck or other parts of the fetus's body is a diagnosis that is made by one in three pregnant women.

Almost every third woman hears on ultrasound: "Your child has an umbilical cord entanglement." Future mom goes into a panic asking a bunch of questions to the doctor.

But do not worry, since in most cases, such a diagnosis does not pose any danger to the fetus. Before the delivery process, the baby can both unravel and again get entangled in the umbilical cord.

Why does the umbilical cord entwine the neck?

The umbilical cord or umbilical cord consists of connective tissue and three veins. One of them delivers blood to the baby with substances useful for life and oxygen, and the other two remove the baby's metabolic products.

Important: Vessels are protected from exposure to a special jelly-like substance called "Warton jelly". Due to this unique structure of the umbilical tissue, it can withstand heavy loads: compression, squeezing and twisting.

Why does the umbilical cord entwine the neck? This happens when the umbilical cord is too long. The baby rotates, and the umbilical cord forms multiple loops into which the legs or head of the crumbs fall.

Important: Increased fetal mobility is considered a predisposition to the development of such a diagnosis. Factors such as polyhydramnios and hypoxia can contribute to this.

Important: An expectant mother can avoid hypoxia if she does not smoke during pregnancy, but monitors the daily routine, walks a lot on the street and moves a lot.

A pathology such as polyhydramnios occurs due to many reasons:

metabolic disorder in the mother
diseases of the heart and blood vessels
kidney disease
infections
diabetes

Important: Register with an antenatal clinic in early pregnancy. The doctor will prescribe the delivery of tests and the passage of a medical examination. This helps to exclude the presence of pathologies and infections.

Signs of the umbilical cord entanglement of the fetus

The first and main symptom of an umbilical cord entanglement is the excessive activity of the baby. But confirmation of the diagnosis occurs only after laboratory tests.

Signs of the umbilical cord entanglement of the fetus include the following:

When conducting a cardiotocographic study, there is a decrease in the frequency of heart contractions during the period of fetal mobility
When conducting an ultrasound, circular loops of the umbilical cord are visible on the baby's neck
The determination of important indicators is carried out with color Doppler mapping. In this study, the vessels of the umbilical cord are visible on the neck or other parts of the baby's body.

Important: If, after the studies, there is no threat to the vital functions of the fetus, then the doctors will not do anything. The baby can unravel at any time before the onset of labor.

Is it dangerous to entwine the neck of the fetus with the umbilical cord?

The main danger in such a diagnosis is the occurrence of hypoxia.

Important: The expectant mother should walk a lot, eat right and lead an active lifestyle, but in moderation. Large physical exercise can be dangerous to a pregnant woman.

Young parents often ask the question: "Is it dangerous to entwine the neck of the fetus with the umbilical cord?" Doctors distinguish several levels of complexity for this diagnosis:

Single, double or triple cord entanglement
Tight and loose entanglement
Isolated or combined entanglement. In the first case, the umbilical cord wraps around only the neck or only the limbs. In the second case, many parts of the body are confused.

Often doctors diagnose a single, loose and isolated cord entanglement. Such a diagnosis does not pose a danger to the fetus. Childbirth will take place in the usual way, and the midwife will easily untangle the baby's neck as soon as the head appears from the birth canal.

Important: If labor is delayed, then obstetricians give a stimulating injection. This is necessary so that there are no complications and fetal hypoxia does not appear.

Important: If a woman in labor has a tight and multiple entanglement of the fetus, then doctors may prescribe a cesarean section.

Single entanglement of the fetal neck with the umbilical cord, photo

The umbilical cord entanglement can be seen on the computer screen during ultrasound

As mentioned above, a loose and single entanglement of the fetal neck with the umbilical cord is not dangerous for the health and life of the baby. This is a signal for the pregnant woman and her obstetrician.

Important: A woman needs to be more attentive to herself, reconsider the daily routine and diet.

Photos will help you see how this type of cord entanglement looks in the picture.

Double entanglement of the fetal neck with the umbilical cord, photo

This type of entanglement is found in many pregnant women. If the entanglement is not tight, then it also does not pose a threat to the health of the fetus.

Important: Single and double entanglement of the fetal neck with the umbilical cord may disappear before delivery. The local gynecologist will make an appointment medicines to help maintain blood circulation in the uterus and placenta.

In the photo you will see what this type of entanglement looks like.

Three-fold entanglement of the fetal neck with the umbilical cord, photo

If the diagnosis has been made that the umbilical cord is entwined three times around the fetal neck, but without a threat to the health and life of the baby, then you should not panic.

Important: Do not skip the examinations that the doctor prescribes for you. Thanks to various studies, it is possible to timely learn about violations in the development of the fetus and prevent the occurrence of negative consequences.

Look at the photo - this is how this type of entanglement looks like.

Umbilical cord entanglement in the ultrasound photo

Ultrasound when entwining the fetus with the umbilical cord

Umbilical cord entanglement on an ultrasound image

Such a diagnosis as an umbilical cord entanglement of the fetus is made on a routine ultrasound examination (20-22 weeks). Additional ultrasound is not performed when the fetus is entwined with the umbilical cord. The doctor should prescribe Doppler or CTG.

Based on these studies, a conclusion is made about the threat or lack of it for the life and health of the fetus. At the 20th week, the fetus is still small and the entanglement with the umbilical cord does not pose a big threat to it.

Important: The kid can get tangled and untangled several times a day.

Important: If such a diagnosis is made at the 32nd week of pregnancy, then doctors begin to monitor the course of pregnancy and the health of the baby.

How to avoid entanglement with the umbilical cord?

When a woman registers with an antenatal clinic for pregnancy, she is assigned to take tests and conduct various studies. It is necessary to follow all the doctor's recommendations and lead a correct lifestyle.

So how to avoid being entangled with the umbilical cord? What is prevention?

Advice: Go for walks more often, in any weather. Avoid stressful situations and exercise for pregnant women or swimming. Do breathing exercises.

All this is necessary so that oxygen starvation of the fetus does not occur, which causes increased activity baby.

How is a birth with an umbilical cord entwined?

If the entanglement is loose and isolated, then the birth takes place in the usual way. The obstetrician-gynecologist who helps the baby to be born will gently remove the umbilical cord from the baby's neck or leg.

Important: Such childbirth does not pose a danger to either the baby or the mother.

But, how is childbirth with an umbilical cord entwined, if the umbilical cord is tightened tightly? In this case, doctors observe the baby's heartbeat, control is carried out every half hour.

Important: If the heartbeat remains normal throughout the entire period of labor, then delivery is carried out in the usual way. If the rhythm is disturbed, doctors prescribe to the woman in labor drugs that stimulate labor.

Important: If something does not start to go according to plan (hypoxia or asphyxia occurs), then the doctor urgently performs a cesarean section in order to quickly get the baby out and help him and the mother.

Do not panic, because such a diagnosis is not always a threat to the baby. The doctor will prescribe an examination and blood and urine tests.

So, what to do when the fetus is entwined with the umbilical cord? Advice and feedback from women who have given birth and have been diagnosed with this during pregnancy can help you cope with anxiety.

Provide your little one with a constant flow fresh air... Take a walk, ventilate the living space
Do breathing exercises, gymnastics for pregnant women. Try not to be nervous so that there is no adrenaline rush into the blood
Trust your doctors during labor and do what they say
Lead a healthy lifestyle, eat vegetables and fruits. Do not overeat so as not to overwhelm your internal organs... Indeed, the health and metabolic processes of the child depend on the good work of your body.
If the doctor has made such a diagnosis, do not use dubious ones for treatment. folk recipes, exercises. All this will not help "untangle" the umbilical cord, but can only aggravate the situation.

Be prudent! Seek advice only from a doctor who monitors pregnancy. Then you will be fine!