Untangling the mystery of umbilical cord mishaps
INTERRUPTION of foetal blood flow in the umbilical cord (the link between the mother and foetus) can have serious health effects on an unborn child.
INTERRUPTION of foetal blood flow in the umbilical cord (the link between the mother and foetus) can have serious health effects on an unborn child. Agnes Kyotalengerire writes about umbilical cord accidents and how serious they can be, especially at birth
Talk of the umbilical cord twisting or wrapping around a foetus’ neck is common in the labour suit. According to Dr. Andabati Gonza, a gynaecologist and obstetrician at Mulago Hospital, umbilical cord twisting is categorised among cord accidents.
Gonza defines cord accidents as a situation where the blood flow to the baby through the cord is disrupted.
A foetus is attached to the mother by the umbilical cord, which has blood vessels through which blood flows from the baby to the placenta and back.
Blood carries nutrients (food) and oxygen to the baby and waste products from the baby, therefore, the umbilical cord and placenta work together to form the lifeline of the baby in the womb. When the umbilical cord blood vessels get blocked, a foetus suffocates while still in the womb.
Causes
Dr. Daniel Zaake, a gynaecologist and obstetrician at Nsambya Hospital, says umbilical cord twisting or wrapping is a common occurrence in early pregnancy, especially when the foetus is so small that it easily moves around in the womb.
Zaake, however, affirms that the condition commonly occurs if the umbilical cord is longer than usual. He notes that the condition can only be detected before birth using an ultrasound scan.
He says under normal circumstances, twisting or wrapping gradually happens as the baby moves around, and unwraps itself. However, he notes that the condition gets complex at birth when the cord gets stretched tightly on the baby’s neck.
This blocks the umbilical blood vessels, suffocating, or strangling the baby. Zaake says if this condition is detected early during birth, the mother is operated upon to deliver the baby or the baby may die.
Obstracted labour
Gonza explains that here, the baby gets stuck on its way either because it is too big or the mother’s bones are too narrow to allow a normal birth. “If this continues for some hours, pressure in the womb increases, cutting off blood flow in the umbilical cord.
This automatically suffocates (strangles) the baby,†he explains, adding that in such cases, the baby has to be delivered by caesarian section. If this is not done promptly the baby may be delivered dead, very weak, or may not cry.
Umbilical cord prolapse
Here, part of the umbilical cord drops out of the birth canal, especially when the ‘waters’ break. The head of the baby then presses the umbilical cord against the birth canal and blocks the blood vessels.
This also suffocates the baby. Zaake says this condition is an emergency that needs the baby to be delivered by caesarian. Alternatively, the doctors can pull out the baby using instruments, if this can be quicker than a caesarian.
Knotting of the umbilical cord
Zaake observes that just like cord twisting, umbilical cord knotting is fairly common and happens in early pregnancy when the foetus has lots of room to move around in the amniotic sac.
“Sometimes, the baby moves through a loop in the cord and accidentally pulls on it, creating a knot around itself,†he explains.
During birth, this knot may tighten, blocking the flow of blood in the umbilical vessels and suffocating the baby.
This condition is usually difficult to detect before birth, but by monitoring the baby closely, a medical worker may notice that the baby is getting tired, and recommend an operation.
While nothing can be done to prevent or fix an umbilical cord knot, doctors often monitor the situation to determine if the knot tightens. In that case, early delivery may be recommended if the baby is found to not be getting enough nutrients or seems to be suffering from foetal distress. A mother is also advised not to sit in order to protect the baby from suffocating.
But in cases where the knot stays loose, it is not considered dangerous for the baby. He cautions that if signs of distress appear during labour, such as blood flow to the baby slowing down or the foetal heartbeat becoming abnormally fast or slow due to the umbilical cord knot tightening, a doctor may perform a caesarian section or monitor the baby carefully to see if the situation improves.
According to Mulago statistics, about two to three cord accidents occur in a month. Though the frequency of the accidents varies, stillbirths (when a baby is born dead) occur approximately in one out of every 100 pregnancies and cord accidents contribute to between 2% and 4% of stillbirths.
Prevention
According to Dr. Daniel Zaake, a gynaecologist and obstetrician at Nsambya Hospital, some cord accidents are random in nature and cannot be prevented, although sometimes if the problem is detected in time, medical workers may recommend early delivery if the baby is in significant distress.
Gonza encourages notifying the doctor if the baby is moving less than usual in late pregnancy. For other cord accidents that occur after medical risk factors, for example having too little amniotic fluid, an obstetrician (specialist in child birth) can sometimes pick up signs for these conditions during antenatal care and watch the expectant mother more closely to detect problems early and decrease the risk of stillbirth.
Martha’s story
I was newly-wed and in my late twenties. During the second trimester of my pregnancy, I felt the foetus actively kick and turn in the womb and this excited me. I did not have difficulty conceiving, but being a fist-time mother, the activity was rather too much.
During my antenatal visits, the doctor revealed that my baby was small, so it had a lot of space to play and kick. I was advised to eat sufficient and balanced meals to enable the foetus grow healthily.
In the third trimester, I realised the activity in my womb was reducing. By the ninth month there was completely no foetal movement. Upon delivery, I had a still birth with the umbilical cord twisted thrice around my baby’s neck.
Talk of the umbilical cord twisting or wrapping around a foetus’ neck is common in the labour suit. According to Dr. Andabati Gonza, a gynaecologist and obstetrician at Mulago Hospital, umbilical cord twisting is categorised among cord accidents.
Gonza defines cord accidents as a situation where the blood flow to the baby through the cord is disrupted.
A foetus is attached to the mother by the umbilical cord, which has blood vessels through which blood flows from the baby to the placenta and back.
Blood carries nutrients (food) and oxygen to the baby and waste products from the baby, therefore, the umbilical cord and placenta work together to form the lifeline of the baby in the womb. When the umbilical cord blood vessels get blocked, a foetus suffocates while still in the womb.
Causes
Dr. Daniel Zaake, a gynaecologist and obstetrician at Nsambya Hospital, says umbilical cord twisting or wrapping is a common occurrence in early pregnancy, especially when the foetus is so small that it easily moves around in the womb.
Zaake, however, affirms that the condition commonly occurs if the umbilical cord is longer than usual. He notes that the condition can only be detected before birth using an ultrasound scan.
He says under normal circumstances, twisting or wrapping gradually happens as the baby moves around, and unwraps itself. However, he notes that the condition gets complex at birth when the cord gets stretched tightly on the baby’s neck.
This blocks the umbilical blood vessels, suffocating, or strangling the baby. Zaake says if this condition is detected early during birth, the mother is operated upon to deliver the baby or the baby may die.
Obstracted labour
Gonza explains that here, the baby gets stuck on its way either because it is too big or the mother’s bones are too narrow to allow a normal birth. “If this continues for some hours, pressure in the womb increases, cutting off blood flow in the umbilical cord.
This automatically suffocates (strangles) the baby,†he explains, adding that in such cases, the baby has to be delivered by caesarian section. If this is not done promptly the baby may be delivered dead, very weak, or may not cry.
Umbilical cord prolapse
Here, part of the umbilical cord drops out of the birth canal, especially when the ‘waters’ break. The head of the baby then presses the umbilical cord against the birth canal and blocks the blood vessels.
This also suffocates the baby. Zaake says this condition is an emergency that needs the baby to be delivered by caesarian. Alternatively, the doctors can pull out the baby using instruments, if this can be quicker than a caesarian.
Knotting of the umbilical cord
Zaake observes that just like cord twisting, umbilical cord knotting is fairly common and happens in early pregnancy when the foetus has lots of room to move around in the amniotic sac.
“Sometimes, the baby moves through a loop in the cord and accidentally pulls on it, creating a knot around itself,†he explains.
During birth, this knot may tighten, blocking the flow of blood in the umbilical vessels and suffocating the baby.
This condition is usually difficult to detect before birth, but by monitoring the baby closely, a medical worker may notice that the baby is getting tired, and recommend an operation.
While nothing can be done to prevent or fix an umbilical cord knot, doctors often monitor the situation to determine if the knot tightens. In that case, early delivery may be recommended if the baby is found to not be getting enough nutrients or seems to be suffering from foetal distress. A mother is also advised not to sit in order to protect the baby from suffocating.
But in cases where the knot stays loose, it is not considered dangerous for the baby. He cautions that if signs of distress appear during labour, such as blood flow to the baby slowing down or the foetal heartbeat becoming abnormally fast or slow due to the umbilical cord knot tightening, a doctor may perform a caesarian section or monitor the baby carefully to see if the situation improves.
According to Mulago statistics, about two to three cord accidents occur in a month. Though the frequency of the accidents varies, stillbirths (when a baby is born dead) occur approximately in one out of every 100 pregnancies and cord accidents contribute to between 2% and 4% of stillbirths.
Prevention
According to Dr. Daniel Zaake, a gynaecologist and obstetrician at Nsambya Hospital, some cord accidents are random in nature and cannot be prevented, although sometimes if the problem is detected in time, medical workers may recommend early delivery if the baby is in significant distress.
Gonza encourages notifying the doctor if the baby is moving less than usual in late pregnancy. For other cord accidents that occur after medical risk factors, for example having too little amniotic fluid, an obstetrician (specialist in child birth) can sometimes pick up signs for these conditions during antenatal care and watch the expectant mother more closely to detect problems early and decrease the risk of stillbirth.
Martha’s story
I was newly-wed and in my late twenties. During the second trimester of my pregnancy, I felt the foetus actively kick and turn in the womb and this excited me. I did not have difficulty conceiving, but being a fist-time mother, the activity was rather too much.
During my antenatal visits, the doctor revealed that my baby was small, so it had a lot of space to play and kick. I was advised to eat sufficient and balanced meals to enable the foetus grow healthily.
In the third trimester, I realised the activity in my womb was reducing. By the ninth month there was completely no foetal movement. Upon delivery, I had a still birth with the umbilical cord twisted thrice around my baby’s neck.