At what week is it easy for the umbilical cord to wrap around the neck?

For pregnant women, the umbilical cord around the neck is a situation that no one wants to face, because other cord wrapping around the neck may cause fetal hypoxia and even pose a certain threat to the life and health of the fetus. Therefore, during pregnancy, girls should follow the doctor's advice and go to the hospital for check-up in time to avoid the occurrence of umbilical cord around the neck, and they should also have a certain understanding of relevant knowledge. So, at how many weeks is it likely for the umbilical cord to wrap around the neck?

1. Causes

Umbilical cord around the neck is likely to occur when the umbilical cord is too long, the fetus is too small, the amniotic fluid is too much, and the fetal movement is too frequent. When the umbilical cord is wrapped around the fetus and then the fetus passes through the umbilical cord loop to form a true knot, it is very likely to lead to a lack of blood supply to the fetus, causing ischemia and hypoxia. Umbilical cord prolapse is prone to occur when the fetal presenting part cannot be connected. It is mostly caused by abnormal fetal position, high floating fetal head, or cephalopelvic disproportion, small fetus, excessive amniotic fluid, and too long umbilical cord. Causes of umbilical cord around the neck: The umbilical cord around the neck is related to its length and fetal movement. For example, frequent spontaneous rotation of the fetus or external version can lead to its occurrence. For a full-term infant whose umbilical cord is wrapped around the neck for one week, the umbilical cord length needs to be 18 to 20 cm. The more times the umbilical cord is wrapped around the neck, the longer the umbilical cord is. However, a short umbilical cord can also wrap around the neck.

Since umbilical cord around the neck is very common, it does not necessarily mean a high-risk pregnancy. However, we need to be aware of the adverse effects of umbilical cord around the neck on the perinatal fetus. Patients with fetal heart rate decelerations before and during delivery may have significantly increased perinatal morbidity and mortality during delivery. Strengthening fetal monitoring before and during delivery and choosing the correct delivery method can reduce the perinatal morbidity and mortality of umbilical cord around the neck.

2. Diagnosis

With the popularity of B-ultrasound, this technology is often used to diagnose the presence of umbilical cord entanglement before delivery. In addition, the use of electronic fetal heart monitoring can also help diagnose the presence of umbilical cord entanglement. Especially during labor, frequent listening to the fetal heart rate or fetal heart rate monitoring can timely understand whether the fetus is in a dangerous condition. Doctors can make timely judgments based on this information and decide how to deal with it.

III. Treatment and Monitoring

1. Routine monitoring

The monitoring of umbilical cord around the neck is consistent with normal pregnancy monitoring and there is no need to cause excessive panic. Pregnant women also need regular prenatal checkups and learn to count fetal movements. If the fetal movements are too many or too few, they should go to the hospital for examination in time. It is not recommended for pregnant women to listen to the fetal heart rate routinely, because the normal or abnormal variations of the fetal heart rate need to be analyzed by professionals. Self-listening to the fetal heart rate often causes too many misunderstandings, psychological anxiety and unnecessary interventions.

2. Delivery method

Umbilical cord around the neck is not an indication for cesarean section. Because the incidence of umbilical cord around the neck is very high, it does not mean it is a pathological condition. Strengthening monitoring during labor will not increase the incidence of fetal/neonatal morbidity with umbilical cord around the neck.

Before delivery, B-ultrasound can be used to check whether there are umbilical cord pressure marks on the fetal body to confirm the diagnosis and check whether entanglement affects the health of the fetus. Fetal electronic monitoring can be used to observe changes in fetal heart rate. If there is irregular deceleration of the fetal heart rate or the variation is too large, it should be considered that the umbilical cord is being pulled or squeezed. The treatment of umbilical cord entanglement is mainly determined by the progress of labor and the degree of impact of the entanglement on the fetus. If the fetus shows signs of hypoxia at the beginning of labor, a cesarean section should be performed immediately. If abnormalities are discovered during the second stage of labor, the fetus should be delivered quickly. If the umbilical cord is found to be too tightly wrapped during delivery, it should be clamped and cut immediately.

3. Other progress

The resistance index of the middle cerebral artery (MCA) and umbilical artery (UA) in fetuses with umbilical cord around the neck in late pregnancy is better than its resistance index in measuring intrauterine hypoxia in fetuses with umbilical cord around the neck. It can detect intrauterine hypoxia in fetuses with umbilical cord around the neck early and make a diagnosis before fetal distress occurs, which has important clinical value.