An umbilical is the lifeline from an unborn child to the mother. It’s responsible for supplying nutrients and oxygen from the mother’s bloodstream to the infant’s bloodstream, as well as supplying a blood supply to the infant and eliminating wastes. Without it, an infant cannot survive during the gestational period. Once an infant is delivered, the umbilical is severed and babies begin to breathe on their own. However, there are several umbilical cord problems that can arise and put infants at risk for serious health problems.
Common Umbilical Cord Problems
Umbilical Cord Prolapse
Umbilical cord prolapse is a problem that occurs when the umbilical cord drops through a mother’s open cervix during labor and delivery. Consequently, the umbilical is dropped before the infant’s head during delivery, which can cause the cord to get trapped or wrapped around the baby’s body. According to the Cleveland Clinic, 1 in every 300 births will experience umbilical cord prolapse.
The most common reasons for umbilical cord prolapse include:
- Breech delivery
- Premature delivery
- An excessive amount of amniotic fluid
- An umbilical cord that’s unusually long
If physicians don’t detect and treat an umbilical cord prolapse quickly, the infant may be deprived of oxygen, leading to a host of medical issues, including long-term cognitive problems, cerebral palsy, and in severe instances, infant death.
A nuchal cord occurs when the umbilical cord becomes coiled around an infant’s neck, most often in a single coil but in some cases, multiple coils. Nuchal cords occur in around 1o to 30% of all births and is seen more often with male infants.
Sometimes a nuchal cord happens for no apparent reason. However, a few of the common risk factors include:
- Carrying twins
- Large infant size
- Breech or shoulder position during birth
- Excessive amniotic fluid
Although most nuchal cord issues are solved before delivery, if left untreated, an infant is at risk for:
- Restricted blood flow
- Decreased oxygen
- A decrease in fetal development
- Fetal heart rate abnormalities
Umbilical Cord Knots
Umbilical cord knots occur when an infant maneuvers around in amniotic fluid and moves through the umbilical cord, creating a knot. The knot usually remains loose, but can constrict and tighten during delivery. While the knot is loose, there generally isn’t a need to worry, but if the knot becomes too tight and not detected and treated immediately, the infant may experience oxygen loss, decreased blood flow, and in some instances, death.
According to the National Institutes of Health (NIH), cord stricture is a common cause of fetal death, typically during the 2nd trimester, before birth. The cause of cord stricture is unknown, yet occur in around 19% of fetal deaths. Since this type of umbilical problem is difficult to detect during the prenatal period, fetal death is heightened. If the infant survives, a series of medical conditions may follow, including a cleft lip, septal defects, and trisomy 18.
Umbilical Cord Cysts
Umbilical cord cysts occur when an abnormal growth appears on the umbilical cord. The growths are classified as either false cysts (filled with fluid), or true cysts (remaining cells from fetal development). Umbilical cord cysts can be detected and treated during the first trimester, yet if not detected or left untreated, birth defects may follow.
Birth Injuries Due to Umbilical Cord Problems
It’s important to note that umbilical cord problems are not considered birth injuries themselves as most happen due to causes that can’t be prevented. However, if a physician fails to detect the problem and treat it in time, birth injuries may follow. For instance, during labor and delivery, if an infant’s heart rate and other vital signs are being properly monitored, the physician may not realize that the baby is in distress. In turn, loss of oxygen may lead to cerebral palsy and other types of birth injuries.
It’s also important to remember, as previously mentioned, that not all umbilical cord problems arise during childbirth. With proper fetal monitoring and ultrasounds, certain problems can be detected early on. The issues become more apparent as the pregnancy nears its end, but if detected, a scheduled C-section (from 35 weeks gestation and on) may dramatically reduce the chances of infant death or other health issues.
Umbilical Cord Research and Additional Resources
Research into umbilical cord problems and treatment is ongoing. Advocates, as well as non-profit organizations such as the March of Dimes, continue to support the research into umbilical cord issues and abnormalities in an attempt to better understand how these issues develop and how to treat them before the infant suffers from serious health disorders.