Umbilical Cord Complications

The Baby's Life Line

The umbilical cord - that narrow tube that connects the baby to the placenta in the womb - is often referred to as the baby's supply line or life line. That is because it carries the baby's blood to and from the placenta delivering nutrients and oxygen to the baby and removing the baby's waste products. It begins to form five weeks after the baby is conceived and continues growing until the 28th week. By the time it is finished growing it averages between 22 and 24 inches in length. As it grows and gets longer, it most frequently coils around itself.

The Umbilical Cord - Abnormalities

Inside the cord are three blood vessels: one vein and two arteries. The vein carries nutrients and oxygen from the placenta to the baby. The placenta is connected to the mother's blood supply. The two arteries carry waste from the sac back to the placenta where it is absorbed by the mother's blood and disposed of by her kidneys. There is a gelatin-like tissue that cushions and protects the blood vessels called Wharton's jelly.

The umbilical cord can be affected by a variety of abnormalities:

· It can be too long or too short

· It may not connect properly to the placenta

· It may become knotted

· It may be compressed or prolapsed

Sometimes cord abnormalities are discovered before delivery with the use of an ultrasound. However, most of the time they aren't found until after the baby or babies are delivered and the cord is examined.

 

Prolapsed Umbilical Cord is an Emergency Situation

One of the situations that may arise is a prolapse of the umbilical cord. This is where the umbilical cord slips into the vagina after the membranes have been ruptured and before the baby descends into the birth canal. About one in 300 births are affected with umbilical cord prolapse. The baby can put pressure on the cord in the birthing process and end up cutting off the blood and oxygen supply from the placenta. If this situation isn't dealt with immediately it can result in a stillbirth. Most frequently, when it is known that the cord is prolapsed, a cesarean section is performed.

If the membranes rupture and the woman feels something in her vagina it is imperative she get to the hospital immediately. If the baby's heart rate becomes abnormal or irregular after the waters have broken, it could mean a prolapsed cord. A pelvic examination is all that is necessary to verify the situation - it is an emergency and the pressure on the cord must be relieved as soon as possible to prevent trauma, birth defects or death of the baby. There are situations in which risk of an umbilical cord prolapse are increased:

· The baby is in a foot-first breech position

· The mother is in preterm labor

· The umbilical cord is too long

· There is too much amniotic fluid

· The membranes are ruptured in order to speed up labor

· There is a multiple birth

Vasa Previa - Life Threatening Condition

Life-threatening bleeding in the baby may occur if one or more of the blood vessels from the umbilical cord or placenta go across the cervix, underneath the baby. The blood vessels, which are not protected by either Wharton's jelly or the placenta, may tear or may be compressed when the cervix dilates. In either case, whether torn or compressed, there is a high risk the baby will not receive enough oxygen as a result of the pressure on the blood vessels. The condition is known as vasa previa and it occurs in one in 2,500 births.

If vasa previa occurs during delivery and is unexpected, there is a 50 percent chance the baby will be stillborn. However, if the condition is diagnosed by ultrasound, it is possible to circumvent the danger by delivering the baby by cesarean section at around 35 weeks. The risk factors for vasa previa are:

· Abnormal insertion of the umbilical cord into the fetal membrane rather than the center of the placenta

· Placenta previa

· Multiple pregnancy

Read about single umbilical artery, another umbilical cord abnormality that affects babies in this section.

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