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Umbilical cord is around the baby's neck

by Dr. Fred Coleman

question
I am 18 weeks pregnant and my ultrasound scan showed that the umbilical cord was around my baby's neck. My doctor said not to worry. I can't help feeling uneasy about it. Do I have anything to worry about?

answer
You should not have anything to worry about at this stage of your pregnancy. While it is always possible for undesirable outcomes to occur, we see the cord around the neck at delivery in about 30% of all births. In the majority of cases there are no problems. Occasionally there may be some ‘variable decelerations’ on the foetal monitor if the cord is being squeezed or stretched. This slows down blood flow to the baby for a brief time. If conditions worsen you may even need a caesarean to keep the baby healthy. Most babies quickly pass through this stage and normal blood flow resumes, allowing a normal birth.

Earlier in pregnancy, the cord gets wrapped around the baby frequently and often unwraps just as frequently. At 18 weeks the cord and baby just float around in the uterus, getting easily twisted and untwisted. There are stories about too much twisting, ‘cord accidents’ and multiple loops of cord around the baby, all of which are true but these cases are exceedingly rare. While that doesn't help the few families involved, it is extremely rare and there is nothing that can be done to prevent it. One of the concerns that can increase the risk of cord problems is decreased amniotic fluid. This doesn't allow for the free movement of the baby and cord on and off each other, raising the possibility of a cord accident. This is not usually of concern in the middle part of pregnancy. Overall, if you can, try not to worry about it, as the likelihood of a problem is no higher than normal. The chance of damaging the baby is very small.

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