Probably, any expectant mother has heard horror stories about being entangled in the umbilical cord. And if a doctor tells a woman such news during an ultrasound, then the imagination runs wild. After all, it’s terrible what it’s like to have a child in a noose! In fact, everything is not as scary as is commonly believed. Let's try to figure out why.

The umbilical cord as it is

Let's start with theory. The umbilical cord (umbilical canal) is a “tube” that connects the child with the mother until his birth. It consists of three vessels and connective tissue. One umbilical vein is responsible for delivering oxygenated and nutrient-rich blood from the placenta to the baby. And the other two “take” blood with fetal metabolic products.

Thickness

The thickness of the umbilical cord may vary slightly. It depends on how much so-called Wharton's jelly is in it - a special jelly-like substance that protects blood vessels from squeezing. A thickness of one and a half to two centimeters is considered normal. It is these dimensions that indicate a sufficient amount of Wharton’s jelly, and this ensures good blood flow.

Length

The length of the umbilical canal is also not the same. Traditionally there are three sizes:

• short - 40 - 55 cm
• normal - 56 - 70 cm
• long - more than 70 cm

All of these options are considered normal. Only an umbilical cord that is too short is dangerous for the child, as it can interfere with his progress through the birth canal. Fortunately, an absolutely short umbilical cord (shorter than 40 cm) does not occur so often, in 12 - 13% of cases. This is often discovered during childbirth, sometimes it is necessary to resort to an emergency caesarean section, but not always. There is a possibility that the baby will be born naturally.

And one more thing

Despite its apparent unreliability, the umbilical cord is quite strong and can withstand considerable loads. During pregnancy, it can stretch, shrink, and twist without any harm to the baby.

Why does she wrap herself around

It’s simply incredible what an active lifestyle children lead in their mother’s wombs! At short stages of pregnancy, when there is still plenty of room for “baby fitness,” they swim, tumble, and “dance.” And the result of these “exercises” can be entanglement with the umbilical cord. Moreover, this happens very often, but then many kids unravel the knots themselves. So, if your child is still small, then the diagnosis of “umbilical cord entanglement” should not scare you. Most likely, the baby will solve the problem himself and free himself from the bonds. However, he and his condition will now be monitored with special attention.

What types of entanglements are there?

Umbilical cord entanglements are different:

• one-time
• multiple times (two to four times)
• isolated (around one part of the body: legs, arms, neck)
• combined (around several parts of the body at the same time)

What are the consequences?

Although you should not immediately panic if you are informed about an umbilical cord entanglement, this condition cannot be considered completely safe. Each case is individual. Being entangled in a long umbilical cord, even multiple times, as a rule, does not affect the child’s well-being. But a normal or short umbilical cord can compress it so much that it leads to a lack of oxygen. In this case, the baby feels discomfort and tries to free himself, begins to actively move in order to untangle himself. This often works.

However, there are cases when entanglement leads to obstruction of blood flow in the umbilical cord. This can lead to serious hypoxia and requires mandatory medical intervention.

When entanglement is discovered

Did the ultrasound show an umbilical cord entanglement? Most likely, you will be prescribed additional examinations:

It is possible that ultrasound examinations will be performed more often than usual (in difficult situations, even up to several times a week). After all, it is with the help of ultrasound that specialists can assess the general condition of the baby, the dynamics of its growth, the umbilical cord, and draw conclusions about how the fetus feels and to what extent the entanglement of the umbilical cord affects it.

• Doppler

This study helps to identify the characteristics of blood flow in the placenta, umbilical cord and arteries of the baby’s brain. If violations are detected, then this is a reason to prescribe treatment.

• Cardiotocography (CTG)

CTG is prescribed from the 33rd week of pregnancy. Previously, the study was uninformative due to the fact that the fetal cardiovascular system is still immature. A rather long (40-60 minutes) procedure allows you to assess the nature of the fetal heartbeat and the frequency of its movements. This is done using a special device with a sensor, which is attached to the belly of the expectant mother. If the baby is entwined with the umbilical cord, then during his movements a decrease in heart rate is recorded. The more pronounced this sign is, the more serious the problem. Based on the results of CTG, obstetricians-gynecologists draw conclusions about the child’s condition and, if necessary, prescribe treatment.

What to do?

What can be done in case of research-confirmed umbilical cord entanglement?

If the umbilical cord entanglement does not affect the baby’s condition, then no treatment is prescribed. If the fetus suffers, then treatment is mandatory.

The child’s condition in case of moderate disorders is corrected with vitamins and nutrients. In this way, the decrease in the volume of blood supplied to the fetus is compensated, and it receives a sufficient amount of substances necessary for normal growth and development. You may also need drugs that help improve blood flow. Most often, these measures are sufficient to normalize the baby’s condition.

Be carefull!

If on an ultrasound the doctor discovered an entanglement in the umbilical cord, then the expectant mother should listen carefully to herself, because you are the one who can catch the first signals for help that the child gives.

What should you pay attention to?

To the child's movements.

Surely you have already roughly understood, or rather, felt the daily rhythm of your baby: is he a “morning person” or an “owlet”, active or not too active. So, keep in mind that if a baby suffers from hypoxia, then his usual rhythm is disrupted, and the nature of his movements changes.

If the blood flow decreases slightly, then the movements slow down, become more rare, and the baby seems to save energy.

In acute hypoxia, the situation is the opposite: the baby moves actively, literally rushes about, and can even roll over. After all, he suddenly and seriously lacks oxygen. His condition in this case is similar to panic, and sudden movements are, firstly, an attempt to get rid of the bonds that caused hypoxia, and secondly, distress signals, a plea for help.

If the baby suddenly fails to free himself, then the second phase of acute hypoxia begins. An attentive mother will be concerned about the sudden cessation of the baby’s movements after increased activity. This happens because his strength dried up during the previous lull in the struggle.

If you notice that the child has suddenly become quiet after a period of unusual activity, immediately contact a doctor, and not at the district antenatal clinic, but preferably at the maternity hospital.

Umbilical cord entanglement and childbirth

Many people believe that entanglement with the umbilical cord is a direct indication for a cesarean section. However, this is not at all true. Even in the case of repeated entanglement, most often natural childbirth does not pose a danger to the child. It’s just that during such births, long-term monitoring of the baby’s heartbeat is required. If it becomes clear that acute hypoxia has occurred, then there are two options for the development of events:

1. In case of serious deviations in the baby’s well-being in the first stage of labor (the cervix has just begun to open and the moment of birth is still far away), a decision is made to perform an emergency caesarean section.
2. If acute hypoxia makes itself felt during the second stage of labor (the baby’s head has already dropped to the pelvic floor and the moment of birth is close), an episiotomy (dissection of the perineum) is performed. This allows you to speed up the birth of the baby and remove the entangled umbilical cord from his neck.

No matter how strange it may sound, in medicine, umbilical cord entanglement is not considered a pathological condition, because it occurs very often - in 20 - 25% of pregnant women, and in most cases it ends in the successful birth of babies. Therefore, if you were told on an ultrasound that the umbilical cord is entangled, do not be nervous, live the normal life of an expectant mother, try to think positively, take more walks. Only without extreme. Because the release of adrenaline in the expectant mother necessarily affects her child. The baby's motor activity increases, and this threatens even greater entanglement in the umbilical cord. So - calm, and only calm. And everything will definitely be fine.

Photo - photobank Lori

Doctors urge not to dramatize the umbilical cord being wrapped around the neck once for several reasons. To begin with, it is worth undergoing an ultrasound diagnosis, which will show the actual state of affairs. There is not always a direct threat to the life and health of the child, so you should not push the attending physician to take radical action. The less the expectant mother exposes herself to nervous strain, the greater the likelihood of giving birth to a healthy baby. The main thing is, as mentioned earlier, to let the doctors do their job.

Let's look into the details: umbilical cord entanglement, causes and consequences

First, the doctor must determine why there was a single entanglement of the umbilical cord around the fetal neck. Opens a list of possible causes: bad habits, poor diet, addiction to tobacco products, and so on.

Even passive smoking can have a detrimental effect on the health of the fetus, so you should think in advance about how to protect yourself. Other reasons are associated with permanent emotional stress.

The list of negative factors continues with a sharp change in climate or diet. It is strictly forbidden to do this without prior consultation with your doctor.

In addition, the unborn child puts himself at risk if one of the following reasons occurs:

• Upper respiratory tract diseases;
• Prolonged exposure to heat or cold;
• Poor environmental conditions;
• During pregnancy, children in the womb become wrapped in the umbilical cord as a result of the mother's failure to comply with basic rules of personal hygiene.

Medical statistics indicate that double or single umbilical cord entanglement is the result of the influence of internal and external factors. Poor nutrition, bad habits, and stress are just some of the factors, each of which is subject to mandatory medical examination.

Popular wisdom teaches: why umbilical cord entanglement occurs

No matter how strange it may sound, you can find many rational moments in signs. The list opens with the addiction to knitting. It is enough to devote only 1-2 hours a week to this hobby to several times increase the chance of developing pathology. The consequences in this case will not be long in coming, because knitting involves staying in one position for a long time.

People's advice continues to tell expectant mothers about really bad habits. Among these are raising your arms above your head too often. Even if a woman does this only 2-3 times a day, the child’s fate remains unenviable. Each lifting threatens the baby with serious damage. The relationship here is simple. The more the mother moves, the greater the desire of the child in the womb to also be active.

In addition, in folk medicine there are a number of other warnings, it would be useful to pay attention to them:

• It is strictly forbidden to sleep on your back, otherwise the fetus will get tangled in the umbilical cord;
• People around should protect the psyche of the expectant mother from nervous tension, otherwise it is fraught with serious consequences;
• You cannot pose for artists, because staying in one position for a long time provokes a tight entanglement of the umbilical cord;
• If possible, you should avoid watching emotionally intense programs, reading books and news.

Many recommendations of traditional medicine help to find out what and why pregnant women should not do. You should not take literally all the recommendations that penitently, for example, the ban on unraveling a tangle or posing. The reason for the development of pathology during childbirth here is the prolonged stay in one position, and not the photographer’s camera or the artist’s brush.

Physiology of the process: umbilical cord around the fetal neck

Parents know why double or triple entanglement of the umbilical cord is dangerous for the life and health of the child. At the same time, not everyone will say what exactly is hidden behind the physiological aspect of the process. Why might a baby be wrapped? What to do if your baby is confused? To answer these questions, it is necessary to consider the physical structure of the umbilical cord. It is formed from the moment the fetus begins to develop and becomes complete at 24-26 weeks.

At first, the short “ribbon” gradually increases in length. As long as the baby is calmly in one position, he cannot be wrapped around him. As the 28th week approaches, the situation changes. Karapuz actively announces his presence to others.

It happens that during the day the fetus turns over several times or simply kicks. As a result, random double or triple entanglement occurs in the area of ​​the cervical arch.

In order to better understand what the umbilical cord is, you should not listen to what the folk sign says.

Attention is paid only to medical facts:

• The presence of two arteries, one of which is short;
• The umbilical venous flow provides the fetus with nutrients.
• The channel for the delivery of nutrients and the removal of waste products from the fetus is the main function of the umbilical cord;
• Its length does not exceed 15 mm, but this does not help to avoid unpleasant complications.

Two arteries and one vein pass through it. The child’s life depends on their coordinated work. Paradoxically, the umbilical cord complex, on the one hand, provides the child with everything necessary, and, on the other hand, there is always a risk of injury to the newborn.

Diagnosis of the problem: a single entanglement of the umbilical cord around the fetal neck

Before taking therapeutic measures, the doctor performs an ultrasound diagnosis. Its goal is to compare the signs and possible consequences of the problem. In order to make an objective assessment of the health status of the fetus and mother, it is better to make at least two projections. In this case, it is easier for the gynecologist to determine where the node is and how to remove it.

Symptoms play an important role in making a correct diagnosis. The doctor’s task is to determine how many times the entanglement occurs.

According to medical statistics, there are several factors that determine where the loop is located when the umbilical cord is entwined once:

1. Excessive activity of the fetus, which is constantly in motion. The baby is forced to stay in a confined space for some time, where he is unconsciously wrapped around the umbilical cord. If precautions are not taken, this will cause multiple pathologies in the future.
2. Mom's addiction to extreme sports - as doctors' reviews show, this often becomes the cause of the development of pathology.
3. Excessive secretion of amniotic fluid provokes one-time entanglement of the fetal cervix

Time is the doctor’s main ally when making a diagnosis. Based on ultrasound diagnostic data, the gynecologist determines where the single loop comes from. In most cases, the duration of the diagnostic stage does not exceed 2 days. You can see almost immediately how dangerous it is to give birth. Thanks to the presence of a wide arsenal of diagnostic tools, the gynecologist is able to immediately recognize a one-time entanglement.

Surgical intervention by a doctor: double entwining of the umbilical cord around the neck

In this case, it is right to recall the saying that “delay is like death.” Before taking any action, it is necessary to determine the nature of the problems. To a lesser extent, the mother risks the child’s health if there is a loose double entanglement of the fetus’ neck.

The situation is more complicated when, based on the existing groove, the gynecologist concludes that there are one or two loops.

In such a situation, you cannot hesitate, otherwise the fetus may suffocate.

The following factors will provide invaluable assistance to the doctor at the stage of making the correct diagnosis:

• It is possible to more or less accurately diagnose and even prevent entanglement in the umbilical cord starting from the 17th week;
• Doppler testing helps to find out the volume of blood passing through the umbilical cord; if the value is below normal, then this indicates the serious nature of the problem;
• The CTG procedure helps determine how much oxygen the child needs;
• Often it is not necessary to untangle the umbilical cord, because a false positive diagnosis occurs;
• If, for one reason or another, the ovaries are not located, this means that the problem arose against the background of pathological changes in the body.

Childbirth with the umbilical cord entwined around the neck (video)

The expectant mother should visit the doctor's office regularly. In this case, already at the 17th week, it is possible to identify and begin treatment for umbilical cord entanglement in the cervical region. Once the problem is identified, the gynecologist does everything possible to minimize possible consequences. As the day of birth approaches, practical recommendations are developed for a physician who will help the baby come into this world.

The umbilical cord is the connecting link between mother and fetus. This cord provides the baby with everything necessary for growth and normal development and, no matter how paradoxical it may sound, it can become a serious obstacle to the successful birth of a child. One of the complications of pregnancy, which is detected mainly shortly before birth, is the entanglement of the fetus in the umbilical cord. The causes of the pathology and ways to solve the problem are discussed further in the article.

The umbilical cord begins to form 2 weeks after conception. The standard length of the umbilical cord varies from 40 to 60 cm. The structure of the life-supporting organ consists of connective tissue, the umbilical vein and two arteries. The blood vessels are coiled inside the umbilical cord. Through the vein, along with arterial blood, oxygen and nutrients flow from the mother’s body to the embryo, and a little later to the fetus. Venous blood and waste metabolic products flow from the fetal heart to the mother through the arteries. The fetus needs the umbilical cord only for the period of its intrauterine development. After birth, doctors cut the umbilical cord, and the baby begins an independent life.

An umbilical cord whose length exceeds 70 cm is considered by doctors as a potential source of complications. Such a non-standard umbilical cord can tie itself into a knot or wrap itself around the child. Umbilical cord entanglement during pregnancy is a very common occurrence lately. Meanwhile, sometimes it is enough to have at least a general idea of ​​the reasons that cause such a problem in order to exclude them during pregnancy.

Causes of umbilical cord entanglement

In modern society there are still many superstitions, with the help of which previous generations tried to find an explanation for this pathological phenomenon. The expectant mother must have a fair amount of skepticism in order to separate reliable facts from pure fiction. For example, you should not take for granted the fiction that pregnant women should not knit or weave, raise their arms up, or even do exercises in the later stages of an “interesting” position. If a set of physical exercises is selected taking into account medical recommendations, it will only benefit mother and baby.

But the risk factors that we list below should be taken seriously by a pregnant woman, since all of them, to one degree or another, provoke the entanglement of the fetus in the umbilical cord:

• the fetus is in a state of hypoxia;
• the presence in the pregnant woman’s diet of foods and drinks that stimulate the central nervous system. Expectant mothers should not get carried away with dark chocolate, dishes with the addition of fresh garlic, black coffee, tea and cocoa;
• frequent stress and situations that cause excessive excitement and increased adrenaline in the blood of a pregnant woman;
• polyhydramnios.

These factors force the fetus to move more actively in the womb, and if the umbilical cord is too long, the child risks simply getting entangled in it, and then the mother will hear a disappointing diagnosis - the umbilical cord is entangled in the baby’s neck or body. In order to draw up a plan for further action, the violation must be diagnosed promptly and in a timely manner.

Symptoms of umbilical cord entanglement and diagnosis of pathology

The clear and only external sign of a complication is excessive mobility of the child. If the baby does not have enough oxygen, he literally panics, as evidenced by his overly active and chaotic movements: he continually pushes and rolls over.

Advances in modern medicine make it possible to diagnose umbilical cord entanglement as early as the 17th week of pregnancy. If the diagnosis is confirmed at such an early stage, the expectant mother should in no case despair, since doctors do not consider this condition as a pathology, but as an increased risk factor.

In the second trimester of pregnancy, when the space around the fetus still allows it to actively move, the umbilical cord, in addition to being entwined, may become tangled in a knot. Experts classify such nodes into true and false:

• a true node is a serious complication in which the blood vessels are severely constricted, as a result of which the access of vital oxygen to the fetus can be blocked;
• By false knot we mean twisting of the umbilical cord or the development of varicose veins in one of its sections. Although this phenomenon cannot be called natural, it does not pose any danger to the child’s blood supply.

It is possible to find out exactly how the umbilical cord is positioned only through laboratory research. The diagnostic program is as follows:

1. First, a cardiotocographic study (CTG) is performed, which will help find out how the baby is feeling. During the procedure, not only the fetal heart rate is recorded, but also its reaction to its own movements (if CTG is performed during pregnancy) and to an increase in uterine tone (if CTG is performed during childbirth). Based on the results of the examination, it can be judged that the fetus has intrauterine hypoxia due to the umbilical cord being entangled around the neck. A sign of this pathology is the absence or decrease in the baby’s heartbeats.
2. After CTG, an ultrasound examination is performed. This procedure allows you to accurately determine or assume the presence of pathology. Sometimes problems arise with diagnosing umbilical cord entanglement on an ultrasound: it is not always possible to clearly see the picture on the monitor and understand how the umbilical cord is located - around or near the fetal neck. The ultrasound examination procedure does not allow us to examine the fetus from all sides.
3. If the question of the umbilical cord entwining the fetus remains open after an ultrasound, Doppler testing is prescribed. This diagnostic method allows you to reliably determine whether pathology really exists and how dangerous it is for the child. During the procedure, the doctor can see the movement of blood flow in a color image, and also establish the strength and speed of blood flow in different parts of the uterus and placenta.

If the diagnostic results are satisfactory, that is, doctors did not find a threat to the baby’s life, the pregnant woman should have no reason to worry. Often the entanglement resolves spontaneously. By actively moving his arms and legs, the child unravels in the same way he became entangled. Indications for emergency intervention are:

• fetal hypoxia;
• entanglement of the umbilical cord around the baby’s neck against the background of other indications for delivery through cesarean section.

Consequences of umbilical cord entanglement

How this pathology will affect the child’s condition depends on the degree of complexity of the entanglement:

1. Single and multiple (two or three loops) entanglement is determined by how many times the umbilical cord wraps around the child or part of his body.
2. Loose and tight entanglement of the umbilical cord.
3. Isolated (the loop is formed around only one part of the fetal body) and combined (the umbilical cord entangles different parts of the fetal body).

Most often, doctors are faced with a loose, isolated, one-time entanglement of the umbilical cord. In this state of affairs, oxygen deficiency in a child occurs in isolated cases, that is, it is impossible to categorically say that this condition is dangerous for the fetus. Spontaneous birth with a single entanglement of the umbilical cord, as a rule, ends successfully. The doctor strictly monitors the development of labor and constantly monitors the state of the child’s heart rhythm in order to promptly detect the onset of hypoxia. If there is a need to stimulate labor that is protracted for some reason, the woman is given a special injection. As soon as the baby's head appears, the entangled umbilical cord is immediately untangled.

If you have to deal with a tight, combined, double entanglement of the umbilical cord, or only one of these complications coupled with a breech presentation of the fetus, doctors will warn the expectant mother about possible dangers:

• oxygen deficiency, which develops when the umbilical cord stretches and compresses the blood vessels of the baby’s body, limbs or neck too much. This almost always happens when the baby moves through the birth canal;
• narrowing of the spaces between the vessels of the umbilical cord itself due to their excessive tension;
• a sharp deterioration in the blood supply and, accordingly, the nutrition of the child’s body;
• suffocation;
• reflex cessation of fetal cardiac activity;
• placental abruption, followed by inevitable premature birth.

The totality of these consequences and each complication in particular pose a huge danger to the well-being of the baby. Therefore, it is advisable to play it safe, which is what doctors do when performing a planned caesarean section on a woman after 37 weeks of pregnancy. Emergency surgery is carried out immediately after the situation, for one reason or another, gets out of control. At 38 weeks, the baby is already fully developed, formed and ready for independent life. In this situation, expectant mothers should not worry about the fact that they could not carry their baby for the required 40 weeks - this is payment for his right to life. If you refuse a cesarean section in favor of a natural birth, if there is a complex entanglement, the baby may simply suffocate during the birth process.

Prevention of umbilical cord entanglement

Measures to prevent the development of pathology include a correct lifestyle and responsible adherence to the recommendations of the gynecologist. Here's what an expectant mother should do to avoid the problem of the fetus being entangled in the umbilical cord:

• remain calm and in good spirits, no matter what happens;
• spend a lot of time outdoors;
• buy a subscription to the pool - swimming calms the mind and relaxes the body;
• remember everything that the doctor says and advises, never neglect a scheduled visit to the antenatal clinic. If there is a slight circulatory disorder in the fetus, the expectant mother may be prescribed vitamins and nutrients - drugs that will maintain the baby’s vitality against the background of a decrease in natural nutrition. In some cases, you cannot do without medications that stimulate blood flow;
• master breathing exercises, having previously agreed on a set of exercises with your doctor;
• attend yoga classes for pregnant women.

These measures will help prevent the development of hypoxia and, as a result, the baby will be calm and less mobile.

Umbilical cord entanglement: psychological aspect

Some time ago, psychologists began to consider the problem of entwining the fetus with the umbilical cord from a psychosomatic point of view. It turns out that this pathology can affect the physical and psychological health of the baby in the future. Negative consequences, as a rule, do not appear immediately, but only after several years, when the child can already be considered as a conscious person. A sign of such a disorder may be a son or daughter’s categorical refusal to wear turtlenecks with a tight collar and tie scarves around their necks. The problem is so serious that all my mother’s persuasion leads to tears and serious hysterics. In addition, in children whose intrauterine development was accompanied by entanglement with the umbilical cord, attacks of asphyxia are observed in stressful situations.

For parents whose children have such problems, there are special recommendations:

1. If possible, consult a psychologist as early as possible.
2. Do not put things on your baby that can cause a panic attack (socks, scarves).
3. Try not to raise your voice at the child in case of disobedience, so as not to make him worry.

Note that consequences of this nature occur when the umbilical cord is entangled quite rarely, however, parents should know that this is possible.

A woman should discuss all her questions during pregnancy exclusively with doctors. It is the specialist who must decide what to do when the umbilical cord is entangled in the fetus of his patient. The expectant mother will need responsibility and common sense: not a single acrobatic exercise will make the umbilical cord loops unravel. The same applies to dubious traditional medicine recipes. In this situation, only a competent doctor will help.

Umbilical cord entanglement during pregnancy. Video

Any expectant mother always worries that the pregnancy proceeds without complications and that the child develops normally, according to all indicators. Therefore, it is not surprising that a pregnant woman is frightened when she learns that her baby is entwined with an umbilical cord. The situation is further aggravated by numerous stories from gossips about how undesirable and dangerous entanglement is for a child.

Yes, in reality the entanglement of the umbilical cord is pregnancy complication , but with a competent approach to solving the issue and the right tactics, entanglement turns out to be not as terrifying as it might seem initially.

Modern medicine works real miracles: in the presence of entanglement, doctors provide optimal management of pregnancy and - without harming the mother herself and the health of her baby - complete the process of delivery.

In addition to the placenta, the umbilical cord is the main “link” between the child and the mother. It is through it that the fetus receives oxygen, important nutrients, trace elements and vitamins.

The umbilical cord is fully formed around the fourteenth week of pregnancy and its normal length is approximately 40-60 centimeters. At the same time, the length of the umbilical cord is determined genetically.

It is interesting that entanglement with the umbilical cord is most typical precisely in a situation where its length is higher than normal and reaches more than seventy centimeters. The risk also increases with polyhydramnios and increased physical activity of the child.

Umbilical cord entanglement can be detected starting from the seventeenth weeks of pregnancy . But if, nevertheless, the fact of its presence has been established, this does not mean at all that the entanglement will persist until the end of pregnancy: the child is both confused and has every chance of unraveling on his own.

The umbilical cord most often wraps around the baby’s body, limbs, and neck. Even in the latter case, it is not dangerous for the fetus - in the womb, the child does not breathe with the help of the lungs, and oxygen comes to him through the umbilical cord. That is, if the vessels are not pinched in it, then the fetus will receive all the necessary nutrients in full.

The situation can only get worse if the umbilical cord entangles the blood vessels, causing blood flow to be disrupted. The key aspect here will be monitoring fetal hypoxia.

The issue of tension is also important: strong tension can cause premature placental abruption, which is very undesirable. Therefore, careful control over condition of the baby during pregnancy .

The entanglement of the umbilical cord is shown by ultrasound. A combined (around the baby’s neck and arms, legs) or isolated entanglement, tight or not tight, single or multiple, can be detected. If there is a suspicion of umbilical cord entanglement, the pregnant woman is prescribed a series of examinations to determine the presence or absence of danger to the child - first of all, the development of hypoxia.

So, the woman will be prescribed dopleometry- a special procedure with which the necessary information will be obtained about the state of blood flow in the placenta.

Cardiotocography (CTG)- another examination that makes it possible to track the baby’s movements and heartbeat; it can be used to determine the absence or presence of fetal hypoxia.

Doppler mapping will allow you to track how blood moves through the vessels of the umbilical cord. As a rule, such examinations are usually carried out several times throughout pregnancy.

If the baby has not unraveled by the end of pregnancy, closer to the due date the doctor will determine the optimal option for delivery. In most cases, one or two loose entanglements do not pose a danger, which means that childbirth can take place naturally. After the baby is born, the obstetrician will immediately free him from the umbilical cord loops, preventing its strong tension.

And here tight and repeated entanglement can cause asphyxia or hypoxia in the child, and in such a situation, doctors often resort to surgical methods of delivery. So, at a period of 37 weeks, a caesarean section may be prescribed if a deterioration in the condition of the fetus is recorded.

The expectant mother is always worried that the pregnancy will proceed without any complications and that the baby will develop systematically and according to indications. Therefore, it is not surprising that such a relative deviation from the norm as entwining the umbilical cord of the fetus makes the pregnant woman worry. The situation is also aggravated by all sorts of frightening stories from gossips about how dangerous and how undesirable entanglement is for a child. Yes, indeed, entanglement in the umbilical cord is considered a complication of pregnancy, but with the correct tactics of its management, with a rational approach to solving the issue that has arisen, entanglement turns out to be not such a frightening factor. Modern medicine can already work almost miracles: doctors provide optimal management of pregnancy in the presence of entanglement, and successfully complete the delivery process without harm to the mother and the baby. Which once again confirms the popular wisdom that the devil is not as terrible as he is portrayed.

Causes of umbilical cord entanglement

The umbilical cord, in addition to being the main “link” between mother and child. Through the umbilical cord, the fetus receives oxygen, all the necessary nutrients, vitamins and microelements. The umbilical cord is fully formed around the 14th week of pregnancy and normally its length is about 40-60 centimeters. At the same time, the length of the umbilical cord is determined genetically: that is, its indicators will be equivalent to the indicators of the umbilical cord that once connected the pregnant woman to her mother. So, entanglement with the umbilical cord is typical precisely in the case when its length exceeds the norm, and reaches over 70 centimeters. But even in this case, entanglement does not always occur - its risk increases in the presence of increased motor activity of the fetus, which may be caused by the lack of oxygen it experiences: due to hypoxia, the fetus begins to move more actively (on the one hand, due to the discomfort experienced, on the other hand). to obtain additional oxygen).

Polyhydramnios can also cause entanglement. But the presence of the mentioned factors does not always lead to confusion for the baby. Moreover, sometimes entanglement occurs accidentally, for no apparent reason.

Why is entanglement in the umbilical cord dangerous?

You can detect the entanglement of the umbilical cord starting from the 17th week of pregnancy. But, if its fact has been established, this does not mean that the entanglement will remain until the end of pregnancy: the baby, just as it is entangled, can, by constantly moving, unravel on its own. The umbilical cord can wrap around the baby’s body, limbs, and neck; and even in the latter case, it is not dangerous for the fetus - the child in the womb does not breathe with the lungs, oxygen comes to him through the umbilical cord. That is, if the vessels in it are not pinched, then the fetus receives nutrients in full. The situation is aggravated only if, when the umbilical cord is entangled, the vessels are also compressed, as a result of which blood flow is disrupted. This means that the most important aspect in the case of umbilical cord entanglement is tracking whether the fetus suffers from a lack of oxygen - - or not. In addition, the issue of umbilical cord tension is also important: from its strong tension, premature placental abruption can occur, which is extremely undesirable during pregnancy. In this regard, in the case of pregnancy with entanglement, constant monitoring of the condition of the fetus comes to the fore, which is carried out regularly throughout the pregnancy.

Checking for entanglement of the fetus with the umbilical cord begins with an ultrasound examination. The entanglement can be found isolated or combined (around the baby’s neck and legs and arms), tight or loose, single or multiple. If there is a suspicion of entanglement, the pregnant woman is prescribed a number of special procedures that will help determine the presence or absence of danger to the fetus - first of all, the development of hypoxia. So, the pregnant woman will be prescribed dopleometry - a procedure by which the state of blood flow in the placenta is studied. Another examination - cardiotocography (CTG) - will make it possible to track the baby’s heartbeat and movements. By the way, with CTG, during which symptoms of umbilical cord entanglement are detected, it is already possible to establish the presence or absence of fetal hypoxia. The study, called, allows you to see how blood moves through the vessels of the umbilical cord. As a rule, such examinations are carried out several times throughout pregnancy, because, as mentioned above, as a result of physical activity, the baby himself can untangle himself from the loop and the problem of entanglement will resolve itself.

Umbilical cord entanglement: consequences for the child

If this still does not happen, closer to the due date the doctor determines the most optimal option for delivery - depending on the specifics of the entanglement. Loose, single or double entanglement in most cases poses virtually no danger, and therefore childbirth can proceed. After the baby is born, the obstetrician will free him from the umbilical cord loops, preventing its strong tension. But repeated and tight entanglement can cause hypoxia or even asphyxia in the child, and therefore, in such a situation, doctors often resort to surgical delivery. Thus, a caesarean section can be prescribed at 37 weeks and even earlier if deterioration in the fetal condition is recorded.

Due to the lack of oxygen caused by the fetus being entangled in the umbilical cord, its entire body may suffer. First of all, the baby’s nervous system is depressed, metabolic processes in the body are disrupted, and the functioning of internal organs deteriorates. Newborns who have experienced intrauterine hypoxia adapt worse to independent life, have difficulties with the functioning of the respiratory system, and may experience oxygen starvation after birth, in the first days of life. But in most cases, entanglement does not pose any great threat. Worries and fears should arise when the umbilical cord is tightly and repeatedly entangled, as well as when the umbilical cord is under strong tension.

Measures to prevent pregnancy with entanglement come down to the simplest rules of a healthy lifestyle. To avoid the fetus being entangled in the umbilical cord, the expectant mother should walk in the fresh air as much as possible and include breathing exercises in the preparation for childbirth program - this will help saturate the body with oxygen and eliminate the possibility of hypoxia in the baby. You should also avoid doing pregnancy exercises or yoga instead. And under no circumstances should you “unravel” the entanglement using all sorts of folk methods - in the form of using infusions of “charmed” herbs, performing acrobatic exercises according to the recommendations of traditional medicine. In this case, the situation can be further aggravated and undesirable consequences can be provoked.

Especially for- Tatyana Argamakova