{"id":2884,"date":"2018-05-02T21:23:26","date_gmt":"2018-05-02T20:23:26","guid":{"rendered":"https:\/\/10storks.com\/?p=683"},"modified":"2018-05-02T21:23:26","modified_gmt":"2018-05-02T20:23:26","slug":"nuchal-cord","status":"publish","type":"post","link":"https:\/\/imedicalsociety.org\/nuchal-cord\/","title":{"rendered":"Nuchal Cord And Fetal Death: Complate Investigation"},"content":{"rendered":"

Nuchal Cord<\/strong><\/h1>\n

Nuchal cord is a risky situation that occurs during the pregnancy, a condition that may affect the labor and may complicate the delivery of the child. It is a condition that happens in the cases that the cord, the umbilical cord of the baby, is wrapping his neck. If it gets too tight in wrapping the neck, it may reduce the blood flow through the veins, which means that a child would not get enough of oxygen and other vital nutrients and thus affect child\u2019s growth. Further, as one can imagine that giving birth to a child with the umbilical cord encompassing the neck similar to a rope is not an easy task and there is a risk of severe asphyxia and damage to the brain (cerebral palsy).<\/p>\n

In human beings or placental mammals, umbilical cord is a narrow cord of tissue that connects the fetus to the placenta lying in the maternal womb. During pregnancy, umbilical cord develops from the remnants of yolk sac and allantois by the fifth week of fetal development. On average, umbilical cord is 55 cm long with diameter of 1-2 cm. It works as a conduit or passage between fetus and placenta, comprising of two arteries and a vein. It supplies oxygen and provides nutrients to the developing baby and eliminates waste products from the baby. Various complications of the umbilical cord have been studied ranging from false knots to lethal vasa previa. False knots have no clinical significance while vasa previa often ends up with fetal death. Other umbilical cord abnormalities include single umbilical artery, umbilical cord prolapsed, nuchal cord, umbilical cord strictures and cysts. In this article, we will only elaborate nuchal cord and its clinical significance.<\/p>\n

Nuchal cord refers an abnormal condition when umbilical cord loops around the fetal neck for 360 degrees. Nuchal cord is called single, double or triple nuchal cord depending upon the number of umbilical cord loops wrapped around the neck for \u2265360 degrees. History of nuchal cord dates back to 1962 when J. Selwyn Crawford defined it as \u201c360 degrees around the fetal neck.\u201d The incidence of nuchal cord varies with gestational age and associated risk factors. On average, its incidence is 10-29%, which increases with advancing gestation age. There are no specific signs and symptoms of nuchal cord. However, if the baby begins moving less at 37 weeks of gestation, it may be a possible alarming sign of nuchal cord. Additionally, monitoring during labor can identify bradycardia.<\/p>\n

As the child grows in a mother\u2019s womb, it is surrounded by amniotic fluid and is fed by mother through an umbilical cord. The umbilical cord is responsible for bringing both the nutrients and oxygen to the growing organism. This umbilical cord is attached to the wall of mother\u2019s uterus with the help of root-like structure called placenta on one side, and to child\u2019s navel on another side. Therefore, the umbilical cord\u00a0 is the main artery, vein, and a lifeline of a child. If anything goes wrong with it, a child may suffer. Though fortunately, complications related to the umbilical cord are uncommon, and even if they occur they often resolve spontaneously without any medical intervention. Nature has its own ways to resolve the problems. Though sometimes trouble with an umbilical cord may arise.<\/p>\n

Umbilical cord is quite thick with an average diameter of around 3 cm (centimeters ad meters are used to measure umbilical cords). It is also lengthy too, and in most cases, it is about half a meter. Though there are lots of individual variances, thus umbilical cord maybe anything between 20-30 centimeters to even three meters. Yes, in few cases it can get pretty long. After about three months of pregnancy, a child becomes quite an active and starts making lots of movements in the womb. So as one can guess that there is a risk of the umbilical cord getting tangled around a child, after all, it looks like a rope, roughly speaking.<\/p>\n

What is the Situation Known As Nuchal Cord?<\/h2>\n

There is no fixed data on the nuchal cord, the reason perhaps behind this, is that it goes unnoticed in a large number of cases, and moreover the cord position keeps changing during the course of pregnancy. However, experts estimate that it is present in about 10-30% of cases. Right, that number is quite significant, but as we already mentioned, in the vast majority of cases the problem would resolve spontaneously without any medical intervention. in a few cases, this condition may get worse and the umbilical cord may even further tighten around the neck<\/a>.<\/p>\n

In modern times, the nuchal cord can be diagnosed in the majority of the cases through the regular use of ultrasounds. Although earlier ultrasounds were not good enough, however, latest color Doppler\u2019s can detect nuchal cord in more than 80% of cases. Once it has been diagnosed, medical specialists have to make preparations accordingly, in some cases, they may go for cesarean section (C-section) instead of natural birth. In these cases, C-section has to be performed quickly and with particular skills so that to avoid making ischemia worse. Further, after the birth, there is often the need for extra care in a child with a nuchal cord antecedent.<\/p>\n

It is natural to ask if the nuchal cord can kill a baby by strangling? Yes, such risk is always there. Though in the vast majority of cases this situation improves with the progress of pregnancy, however, in a small number of instances it may become worse. In some cases, the umbilical cord may get very tightly wrapped around the neck of the baby thus causing asphyxia. In few cases it may hinder the baby\u2019s growth, in worst few cases it may even lead to baby\u2019s death, though such outcomes are not common. Further, in the nuchal cord, there is a risk that a child may get strangled during the birth process when the umbilical cord is pulled.<\/p>\n

FETAL DEATH IS ALWAYS A POSSIBILITY IN THE CASES OF A TIGHT NUCHAL CORD: YOUR DOCTOR CAN AVOID IT. CHECK IN THIS ARTICLE WHAT CAN YOU DO .<\/figcaption><\/figure>\n

There are two types of nuchal cord: Type-A and Type-B. Type-A nuchal cord freely encircles the fetal neck in a sliding pattern while Type-B nuchal cord wraps around the neck in a locked pattern. Type-A nuchal cord can undo itself spontaneously while type-B nuchal cord cannot undo itself spontaneously. Remember, nuchal cord unlikely develops or corrects itself during labor. If nuchal cord is tightly wrapped around the neck, it may result in catastrophic outcome, presenting as strangulation of the fetus, which can be identified with presence of features such as dusky face, facial bruises, hyoid bone fracture, facial suffusion and conjunctival hemorrhage. Additionally, vagal collapse may occur due to compression of carotid sinuses by the tight loop of umbilical cord. In nuchal cord strangulation, umbilical cord itself works as a noose; hence subjects the developing baby to collapse, as it is the only source of oxygen and nutrition to the fetus. Grading of tight nuchal cord is given as:<\/p>\n