Cord fetal entanglement: causes and consequences

The entanglement of the fetus by the umbilical cord refers to such pathologies that a pregnant woman usually does not realize. The fact becomes obvious only during the passage of the next ultrasound scan of the baby or during CTG, if the entanglement already has negative consequences. Why this happens and what the consequences may be, we will tell in this material.

A cord entanglement is a pathology of pregnancy in which the cord forms a loop around the body, limbs, or neck of a fetus growing in the mother's womb. The consequences of entanglement can be quite unfortunate, and therefore a pregnant woman should understand the essence of the pathological process as best she can to know how to act.

The umbilical cord is an elastic cord, inside which the vessels are located. Two arteries and one vein completely satisfy the vital needs of the baby. Arteries bring up the baby's waste products (urea, creatinine, carbon dioxide) in the placenta, and the vein supplies the baby with fresh, saturated with oxygen, vitamins, water and minerals, maternal blood. Thus, the baby eats, breathes and removes metabolic products.

One end of the umbilical cord is attached to the placenta, usually to its central part, the second - to the front abdominal wall of the child. The cord length is normally from 50 to 70 centimeters. A longer cord gives the child greater freedom of movement, while at the same time creating a more real threat of entanglement.

The state of entanglement by the umbilical cord is recorded, according to medical statistics, for every 5 women in an “interesting position”. Entanglement can occur at any stage of pregnancy, but the second trimester poses the greatest danger - the baby is actively moving, turning over. If by the third trimester he does not succeed in unraveling, the entanglement is likely to continue until the birth, because there is very little room for movement in the uterus in the last third of the gestation period.

Most often, doctors diagnose entanglement around the baby's neck. In this case, complications from the fact of entanglement occur in approximately 10% of cases. If the umbilical cord is short relative to the norm, then entanglement is less dangerous than with a long one (over 70 cm). Excessive excess of the length of the umbilical cord creates a danger not only of double or triple entanglement, but also the occurrence of knots, which can stretch when the cord is pulled. Then the child will be threatened with asphyxiation due to acute oxygen deficiency and intrauterine death.

Very often, the baby is entangled by the umbilical cord when developing fetal hypoxia at an early stage. When the child begins to lack oxygen, it enhances physical activity, trying to get more of the necessary gas. Chaotic movements in the womb become the main cause of the formation of a loop of the umbilical cord around the neck, legs or body of a baby.

Quite often, doctors are faced with "inherited" entanglement, when the daughter, having become pregnant, repeats the maternal scenario. With the polyhydric, entanglement is also not uncommon.A large amount of amniotic fluid creates additional space for movement and somersault, as a result of which the crumb is simply entangled in the umbilical cord. And during the shortage of water, experts say, the umbilical cord can create loops itself, and deprived of the opportunity to dodge due to the small space for movement, the baby is entwined.

Very often, pathology is diagnosed in pregnant women who work in hazardous industries, have contact with harmful substances - varnishes and solvents, paints, toxins, nitrates, as well as expectant mothers who live in large cities with poor environmental conditions. Not least among the reasons given to bad habits during the carrying of the baby - smoking, alcohol, drugs increase the likelihood of developing pathology dozens of times.

Any condition in which the body of the future mother produces more adrenaline is dangerous - the more this hormone, the more active the baby, and therefore the higher the probability of entanglement. These situations include stress, feelings, emotional drops, fear, and even more joy.

Inadequate nutrition of the pregnant woman during gestation also increases the likelihood of entanglement.

The woman herself may not feel the baby’s entanglement with the umbilical cord, but at a certain stage, when the crumb already suffers, she will definitely notice the change in his physical activity. In the initial stages of hypoxia, children move actively, painfully, with neglected and chronic oxygen deficiency, on the contrary, activity decreases.

For physicians, it is not so much the fact of finding a cord loop that is important, but a characteristic of pathology, which includes determining the number of loops. The prediction and choice of the mode of delivery depends on the specific entanglement.

On this basis, a single entanglement is distinguished, in which the umbilical cord is wrapped once around some part of the baby’s body, or multiple (double, triple, four-fold, etc.), in which the number of loops is more than one.

If more than one loop is found, then the type of pathology is determined:

• isolated entanglement - when it loops are located around one part of the body;
• combined - when it loops are located around different parts of the body, for example, around the neck and around the abdomen.

A more relaxed prediction has a poor entanglement - with it there is no compression of the anatomical part of the body of the fetus, the loop exists, but it does not give the kid any pronounced inconvenience. Cases of tight entanglement, which occurs in 10% of cases, are less favorable. When it can be compressed blood vessels of the umbilical cord, which is very likely to lead to suffocation and acute hypoxia, child death.

Detect the problem can doctor ultrasound, starting from 13-14 weeks of pregnancy. It is by this date that the formation of the placenta and the umbilical cord is usually completed. However, at such a time you should not be afraid of the diagnosis - the baby is so small that it is not difficult for him to disentangle himself, get confused again and free himself from his loops again.

The number of loops can be determined by ultrasound scanning with color Doppler ultrasound. This allows not only to calculate the multiplicity, but also to recognize possible violations in the state of the crumbs. Blood flow disturbances in the uteroplacental vessels, as well as slowing or accelerating the heart rate of the baby, can tell about the likely hypoxia.

Cure entanglement is impossible. There is not one obstetric technique, not a single drug that could help to cope with this task. Doctors recommend a woman to calm down, stop nervous and more often visit the antenatal clinic. From the 28th week of pregnancy, a woman can be recommended weekly CTG, as well as an ultrasound with a doppler every two weeks. Tactics of waiting and observation at any time can be interrupted if violations of the baby’s condition are noticed.

In this case, the woman is recommended hospitalization, insist on home treatment is meaningless and dangerous. A woman with a diagnosed entanglement is recommended a complete and balanced diet, taking vitamins that will compensate for the nutritional deficiencies in the baby's body. The absence of stress in the expectant mother will help to avoid loops; herbal light sedatives are recommended to calm her down.

If you have the opportunity to live outside the city in the fresh air, you should definitely use it. Quite often, drugs that help improve blood circulation in the "mother-placenta-fetus" system ("Curantil" or "Actovegin»).

If the entanglement is loose and one-time, the woman is usually allowed to give birth naturally. True, the control of such a woman will be increased: every half hour the doctor will check the indications of CTG sensors to make sure that everything is fine with the child. When there are signs of disruption of the well-being of the crumbs, an emergency caesarean section is performed.

Births with entanglements require high qualifications and extensive experience from obstetricians. The loop with the neck, if it is located there, is removed immediately, as soon as the head is born, the delay is unacceptable. A woman should pay more attention to the choice of a doctor and obstetric institution. The birth certificate that she receives when applying for maternity leave allows her to choose any hospital or perinatal center, based on personal experience or feedback from doctors and other new mothers.

In case of multiple entanglements and his type, natural childbirth is not allowed. Such a pathology is an unequivocal indication for cesarean section. The baby in the womb and without the birth process suffers from a lack of oxygen, and it is not known what the consequences of hypoxia will be in the future. At birth, such a pathology can lead to the death of the baby.

In order to prevent the unpleasant pathology of the umbilical cord, from the first weeks of pregnancy one should take care that the expectant mother does not come into contact with harmful substances, eats well and walks a lot. If her job involves night shifts, a change in working conditions is required. To prevent anemia, you should take iron supplements and take all the necessary tests in the antenatal clinic in time.

Psychosomatic specialists are sure that entanglement with an umbilical cord has its own deep-seated causes and consequences, the knowledge of which will help a woman to avoid difficulties in carrying and raising a child. It is believed that the mere fact of intrauterine discomfort that a child experiences with such a pathology of pregnancy cannot but affect his health and life in the future.

Children, who in the womb were experiencing a entanglement around the neck, for reasons that are not clear at first glance, at a more conscious age, they begin to refuse to wear scarves, ties, and high-necked sweaters. And in stressful situations, such children may experience psychological suffocation attacks, when breathing in and out becomes difficult because of the distant "memory" of the subconscious.

Psychosomatics identifies several reasons why a umbilical cord entanglement may develop in a pregnant woman. Among them, the main place is occupied by the perception of the mother of her child.

The other extreme is excessive love, which, as they often say, “chokes”. Therefore, pathology often occurs in couples who have been waiting for a pregnancy for a long time, and now the expectant mother is ready for anything, if only the crumbs were good.

Also, entanglement can develop in a woman who is unsure of her abilities, is worried about the lack of money or the absence of her husband. In addition, pathologies are more susceptible to women who, being girls themselves, were subjected to violence, ill-treatment or had experience of drowning.

It is believed that a child born with an entanglement will live a hard and uneasy life, and many tests will fall to his lot. To avoid this, from ancient times there is a ritual of reading such babies. In the first year of his life after accepting the Sacrament of Baptism, mothers read over the child "Mother of God, Devo, rejoice." Boys report on the "male" days - Monday, Tuesday, Thursday. Girls - on the "women's" (Friday, Wednesday, Saturday). On Sunday, you can not blame the child.

About hypoxia and entanglement of the umbilical cord, see the following video.