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Nuchal Chord: Causes, Complications, and Management

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The umbilical cord is the connection between the baby and the placenta. It has three vessels which are two arteries, that performs the function of transporting blood from the foetus to the placenta, and one vein, that transports oxygenated, nutrient- rich blood from the placenta to the baby. In short, all baby needs to develop in the womb is provided by the umbilical cord.

The wrapping of umbilical cord around the baby’s neck is referred to as the nuchal cord. Umbilical cord can go over a baby’s neck once, twice or even multiple times but it’s nothing to stress about. Nuchal cord is not caused by anything mother has done, it cannot be prevented but can be well managed.

Unregulated movement of the foetus is the main cause of a nuchal cord which usually occur during the third trimester when the baby swims around in the uterus and play with its umbilical cord. I remember then that the baby used to moved uncontrolably inside me, then i did not even know the implications of his movement I thought he was playing football, though no football pitch in my womb.

The presence of “Wharton’s Jelly” which it’s work is to keep the cord from knots and also protects a healthy umbilical cord from blood vessel compression also keep the baby safe in the womb no matter how many wriggle the baby does.

A mother cannot tell if her baby has a nuchal cord if it has not being revealed by ultrasound during her routine checkup just like mine, the ultrasound never reveal the nuchal cord, so i was not prepared for what i experienced that day neither my doctor too, however my child survived it because some are not so lucky like mine.

According to research, there is no much risk for mother or baby, it is only in rare cases when things is taken for granted that severe complication such as neonatal encephalopathy which can leads to damage of brain occur. Nevertheless, once the ultrasounds had revealed nuchal cord, during the routine scan, then it is the duty of the doctor to monitor the baby carefully during its delivery. Nothing can be done about nuchal cord until delivery even though the ultrasound reveal it. During the delivery, the most common risk from a nuchal cord is if the baby’s heart rate decreases which is caused by shortened flow of blood and oxygen due to entangled cord during contraction. Even, most babies are still born healthy despite the fact that there is decreased heart rate.

Studies show that up to half of nuchal cord resolve before delivery. However, if it does not resolve and ultrasound does not reveal it before delivery then during delivery after the baby’s head comes out the midwife can easily slip the cord over the baby’s head with her finger before the shoulder is delivered, this can be done if the nuchal cord is loose, but if the cord is tight, the midwife may slip the cord over baby shoulder and if this is also not working, the physician may allow the shoulders and body to be born in a somersault, with the cord being unwrapped after delivery. This is called somersault technique, but if the nuchal cord is too tight, then the midwife may clamp and cut the cord before the baby’s shoulders are born.

In African folklore, especially from the Yoruba tribe, it’s believed that a child with nuchal cord on his/her neck will automatically be stubborn, but I don’t see any connection as this phenomenal is what science completely explained. Also, there is this common belief that chicken survival around children born with nuchal cord cannot be guaranteed.

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