Expectant mothers often hear stories about the baby being wrapped in the umbilical cord. What it is? Is umbilical cord entanglement dangerous? Is it possible to avoid it?

When entwined, the free length of the umbilical cord decreases; an umbilical cord that is too short during the pushing period of labor causes the fetus to “spring” in the birth canal - the umbilical cord attached to the placenta can prevent the baby from coming out. In such cases, the doctor usually performs an episiotomy (cut of the perineum) in order to facilitate the birth of the baby. If the fetus is already suffering from hypoxia, vacuum extraction of the fetus or obstetric forceps can be used to speed up the extraction of the child.
Immediately after the birth of the head, the obstetrician frees the neck from the umbilical cord loops, thereby preventing its strong tension and disruption of blood flow through it. At this moment, the woman should not push, which the obstetrician will definitely say. During childbirth with an entangled umbilical cord, it is very important to strictly follow the instructions of doctors: this will reduce the risk of injury to mother and child.

Fourfold entanglement of the umbilical cord around the fetal neck on ultrasound:

With new modern methods of research and monitoring the condition of a pregnant woman, woman in labor and child, entanglement with the umbilical cord is no longer as dangerous as before, and allows you to give birth to a healthy baby.

When your baby moves in the womb, the umbilical cord may wrap around his neck, forming a noose. Why this happens and why it’s dangerous – we’ll find out further.

Definition of pathology

The umbilical cord is also called the umbilical cord and is a structure that resembles a spirally twisted cord. It has the following characteristics:

• gray-blue color;
• matte surface;
• 55-60 cm in length (with normal pregnancy);
• about 2.5 cm thick.

When the umbilical cord lies in loops around the fetus, this phenomenon is called entanglement. According to the classification of this pathology, entanglement occurs only around one part of the fetal body - the neck, but depending on the number of turns, entanglement can be one, two, or multiple.

Single entwinement of the umbilical cord around the fetal neck

Almost 20% of pregnant women face the problem of umbilical cord entanglement. Most often, a one-time entanglement occurs, which does not tighten the neck tightly. There are several reasons and these include:

• Exceeding the length of the umbilical cord. It has a diameter of about 2 cm, and the length varies from 40 to 60 cm. These figures are considered normal, but it can have a length of about 70-80 cm, in such cases women are at risk, since their baby may be entwined with the umbilical cord. These sizes are transmitted genetically and very often coincide with the parents.
• Frequent worries and nervousness, adrenaline rush.
• Increased amount of amniotic fluid (polyhydramnios).

These reasons are not accidental, because a long umbilical cord and polyhydramnios enable the child to move more freely, which is why entanglement occurs.

There are often rumors among pregnant women that if the child moves too actively, then he suffers from hypoxia. In fact, active movements do not indicate anything like that.

When the fetus is 28 weeks old, it will have a daily routine. You can determine when the baby is sleeping or awake. When moving, you need to pay attention to its activity. If the baby begins to move less, then we can conclude that he is not feeling well (there should be at least 10 fetal movements per day). Therefore, if the baby is inactive, then it is necessary to visit a gynecologist and consult with him.

With a single entanglement, natural childbirth is allowed. Many mothers give birth on their own, and as soon as the baby’s head appears, the midwife carefully removes the noose.

Wrapping the umbilical cord around the neck twice

Double entanglement also occurs. If at the time of the ultrasound the baby has reached 37 weeks, it means that he will no longer be able to unravel, since he no longer has enough room to maneuver in his mother’s tummy. But if double entanglement was observed by ultrasound earlier than this period, then there is still a chance that it will again be able to unravel on its own.

Double entanglement somewhat complicates natural childbirth, so the obstetrician must be notified in advance so that the birth goes smoothly.

A lot depends on how exactly the umbilical cord is wrapped. While the baby is in the womb, and the entanglement is not tight, there is no danger, since oxygen continues to flow through the umbilical cord, and not through the trachea. The main thing is that the umbilical cord is not pinched (the baby can crush it himself), so women with the fetus entangled in the umbilical cord are recommended to periodically carry out Doppler measurements.

The woman in labor is allowed to give birth on her own, but everything is still prepared for the operation. If there is the slightest deviation in the health of the fetus, a caesarean section is performed.

Wrapping the umbilical cord around the fetal neck three times

The umbilical cord may also wrap around the baby's neck three times. This phenomenon is not particularly dangerous if it is not tight. The child receives oxygen through the umbilical artery, and if the entanglement is not tight, asphyxia does not occur. If there is a three-fold tight entanglement, then oxygen starvation may occur. Gynecologists determine this by Dopplerography and CTG. With such a disorder, even with the help of a stethoscope it is possible to determine arrhythmia in a child.

At longer periods, labor begins to be stimulated. If the cervix is ​​not dilated sufficiently, the baby is removed by cesarean section. But the operation should be based on additional reasons:

• the fruit is heavy;
• the child is across;
• a narrow pelvis in a woman in labor;
• hypertension is detected.

What are the dangers of the umbilical cord being entwined around the fetus’ neck?

Children with double or triple entanglement are at some risk. If there is a tight entanglement or compression of the umbilical cord, the child experiences a lack of oxygen and nutrients supplied to the child through the blood. His health immediately deteriorates, which can be registered on CTG.

The state of fetal health also depends on the duration of its oxygen starvation. Rarely, but still it was observed that if the umbilical cord was tightly tied, and its length was significantly reduced, then the fetus experienced placental abruption. Therefore, if you do not consult a doctor in time when bleeding occurs, you may lose your child.

The entanglement of the umbilical cord also threatens that the baby may injure the cervical vertebrae during childbirth. Therefore, the obstetrician delivering the baby must act according to the instructions.

All children are different and entanglement situations are also different. For example, some children do not experience any consequences, while others develop vegetative-vascular disorders.

Preventive measures

It is worth noting that the entanglement is formed due to the fact that the baby is actively moving inside the fetal bladder, twisting the umbilical cord and getting into the loop. But at the same time, the parent can minimize the risk of entanglement if she follows some rules:

• Take daily walks fresh air.
• Sleep for at least 7 hours, and during sleep ensure fresh air enters the room.
• Constantly be under the supervision of a gynecologist and follow all his recommendations.
• In the third trimester of pregnancy, undergo CTG - a procedure that allows you to identify the pattern of the baby’s heartbeat and activity. Based on its results, the doctor gives his recommendations.

If you find entanglement, do not be nervous. The doctor may prescribe medications that support blood circulation in the fetal-placental area.

Video: Umbilical cord entanglement during childbirth

IN next video The expert will tell you in detail what pregnant women should know about the umbilical cord entwining around the fetus’s neck:

Most often, the child is wrapped around once, and not tightly. Very rarely, repeatedly, in combination, that is, when the neck and leg are fixed. A single wrap is not dangerous. Double and triple entanglements are considered more complicated. Sometimes, when they are detected, a planned caesarean section is performed. Prevention is the observance of a daily routine and complete calm by the woman in labor.

According to statistics, 20% of all births are accompanied by entanglement of the umbilical cord, and the most common option is the presence of a single entanglement in the fetal neck area.

Due to the development of the method during pregnancy, as well as a thorough study of the blood flow of the fetus, it has become very easy to diagnose entanglement.

But what does this information mean? This complication often frightens pregnant women.

Most women are concerned about questions such as: is entanglement of the umbilical cord always accompanied by impaired circulation of the fetus? Is this an indication for surgery? Let's try to figure out how dangerous this is and whether a caesarean section is justified in this situation.

In order to understand what functions the umbilical cord performs, it is necessary to know its simplified anatomical structure. The umbilical cord is a helically twisted tube through which vessels pass: two arteries and one vein. These vessels are surrounded by tissue that has a jelly-like consistency, due to which it received the name “vartanov jelly”.

So, the umbilical cord is an important part of the feto-placental system. In addition to the transport function (transfer of blood to the fetus), the umbilical cord is involved in very important process– regulation of the flow of incoming blood. Due to changes in the diameter of the umbilical cord under the influence of various factors, the volume of blood flowing to the fetus can change. As mentioned above, the lumen of the umbilical cord contains Vartan jelly.

This fabric protects arteries and veins from compression and essentially performs a shock-absorbing function. It is for this reason that arteries and veins are protected from influence external factors. This function is extremely important for maintaining optimal blood flow even when exposed to adverse factors.

What are the causes of entanglement?

Considering that entanglement occurs in 20-25% of women in labor, there are many reasons that cause this complication:

• Increased fetal growth can lead to the appearance of an umbilical cord loop in the neck.
• creates additional opportunity for the appearance of entanglement.

As the volume of amniotic fluid increases, the space for fetal movement increases, as a result of which a loop of the umbilical cord around the fetal neck may appear even at very early stages. later pregnancy, and in rare cases even immediately before childbirth.

At first glance, the connection between hypoxia and the appearance of entanglement is completely incomprehensible. But it is precisely the insufficient supply of oxygen-enriched blood that causes an increase in the motor activity of the fetus.

Physiologically, this fact is explained as follows: muscle contractions help increase the speed of blood flow in the fetal circulatory system. And therefore, the fetus, experiencing hypoxia, makes movements more often, as a result of which the risk of entanglement increases.

The whole complexity of this situation lies in the fact that when an umbilical cord loop appears in the neck area, blood flow can worsen, as a result of which hypoxia becomes more and more pronounced.

This creates a “vicious circle” in which the fetus’s condition gradually worsens.

• High birth parity.

Parity refers to the number of previous pregnancies and births a woman has had. The higher this figure, the lower the tone of the uterus, as well as its contractility. As a rule, in women who have given birth many times, the anterior abdominal wall is overstretched, which creates the preconditions for. Due to the increase in space inside the uterus, there is a high probability that the fetus will have high motor activity.

• The umbilical cord is too long.

Normally, the length of the umbilical cord should be about 50 cm. A significant increase in this parameter carries an additional risk of entanglement. With a very long umbilical cord, double or even triple entanglement is possible.

Methods for diagnosing umbilical cord entanglement around the fetal neck

The main method for diagnosing this complication is ultrasonography using the Doppler effect.

Thanks to this technique, it is possible to thoroughly study the number of vessels, as well as the nature of blood flow in them. Thanks to Doppler, arteries are colored red and veins are colored blue.

By counting the number of vessels around the fetal neck, it is possible to determine with a high degree of certainty what kind of entanglement (single, double or triple).

If there are 3 vessels in the neck area, then the entanglement is single, if 6 – double, if 9 – triple.

Another important advantage of a Doppler study is to determine whether there is a violation of blood flow in the arteries, because the cord entanglement can be tight or loose. By determining the speed of blood flow in the vessels, you can understand whether there are any disturbances.

Consequences of a single entanglement

The dangers that entanglement poses are different during pregnancy and during childbirth.

During pregnancy:

1. If the entanglement is not tight and is not accompanied by impaired blood flow, then, as a rule, there are no complications during pregnancy.
2. If, according to a Doppler study, a disturbance in the speed of blood flow through the arteries of the umbilical cord is detected, then the following pathological conditions may occur during pregnancy:

• Delayed fetal development. With prolonged hypoxia, fetal weight can significantly lag behind normal values.
• Severe tightening of the umbilical cord loop can cause acute intrauterine fetal hypoxia, which is an indication for.

Complications during childbirth:

1. Tighter tightening of the loop as the baby passes through the birth canal.

It is no coincidence that in the presence of entanglement, every fourth birth is accompanied by hypoxia.

1. Asphyxia (breathing problems) in a child after birth.
2. This happens especially often if the umbilical cord is short (less than 50 cm).

In this case, the umbilical cord is not long enough, and as the baby moves through the birth canal, it becomes increasingly tightened. Such children are born with a bluish tint to the skin. In severe cases, they may even require resuscitation.

1. Placental abruption during childbirth.

If the tension of the umbilical cord becomes excessive, placental abruption and bleeding may begin. This is a very dangerous complication that threatens the life of the fetus.

1. Death of a child while passing through the birth canal.

This happens extremely rarely, and, as a rule, with a single entanglement of the umbilical cord around the fetal neck, such a situation is practically impossible. However, if, in addition to entanglement, there are other obstetric pathologies (presence of a true node), incorrect position of the fetus, then the likelihood of such an unfavorable birth outcome increases.

Thus, complications of umbilical cord entanglement can be very serious, but they usually arise in the presence of additional obstetric pathologies: a truly short umbilical cord, a narrow pelvis, the presence of additional nodes on the umbilical cord, etc.

Features of labor management with a single entanglement

In order to minimize complications that may arise during childbirth, you must adhere to the following rules:

• Be sure to measure the size of the pelvis, and also calculate the estimated weight of the fetus.

The pelvis should not be narrow, otherwise this may cause compression of the umbilical cord around the baby’s neck as it passes through the birth canal.

• In the first stage of labor, it is necessary to constantly monitor the fetal heartbeat using.

Long-term recording will help to figure out if there are any disturbances in blood flow in the vessels of the umbilical cord.

• During the pushing period, it is necessary to listen to the heartbeat after each push.

If after pushing the heartbeat is restored to normal levels, then labor can continue.

• You cannot use medications that increase the contractility of the uterus (for example, Oxytocin), as they can provoke and aggravate hypoxia.
• During childbirth, it is preferable to administer drugs that improve energy processes: “Cocarboxylase”, “Glucose solution with ascorbic acid”, etc.
• You should treat the drug "" with caution.

Despite the fact that this medicine is prescribed for hypoxia and improves uteroplacental blood flow due to its effect on circulation in small vessels, we must not forget that Actovegin is made from natural ingredients that can cause a severe allergic reaction in the form of anaphylactic shock.

In what cases is umbilical cord entanglement an indication for cesarean section?

A single wrap around the neck is not an indication for surgical delivery.

However, operative delivery is fully justified when there is a combination of entanglement and the following obstetric complications:

• Development during childbirth.
• A combination of entanglement and other pathologies of the umbilical cord (true knot, anomaly of attachment of the umbilical cord to the placenta).
• Discrepancy between the size of the fetal head and the parameters of the pelvis.

conclusions

Umbilical cord entanglement is a borderline condition that can be completely asymptomatic or cause very serious complications, life threatening fetus

In order to determine the degree of danger, as well as the risk of developing pathological conditions, you should not neglect additional studies before childbirth: Doppler examination and identification of concomitant pathologies are mandatory.

When several obstetric factors complicating the course of labor are combined, the likelihood of an unfavorable outcome increases sharply. Therefore, careful and attentive attitude towards mother and child during pregnancy and childbirth is the most the main task for the obstetrician.

So, you have decided to become a happy mother by planning a pregnancy. This wonderful time of anticipation will make not only your heart tremble, but also the hearts of all those close to you.

Everyone will worry about you in their own way and empathize with you, because life is so unpredictable.

And literally every hour, every minute and every moment a woman in an interesting position needs to be extremely careful and attentive, because not only your health, but also the health of the unborn baby, and the life of both of you now depends on you.

How well and calmly your pregnancy proceeds will largely determine your future. physical state and the health of the child in general.

You will need to monitor yours more carefully, avoid many harmful factors , for example, drinks containing even small doses of alcohol, cigarette smoke, the use medicines and many different external factors such as:

• stress, quarrels and worries, even those that seem insignificant at first glance;
• any change in climate, especially for people suffering from diseases of the respiratory system;
• hypothermia and overheating equally;
• environmental problems, including the slightest failure to comply with the simplest hygiene standards.

The enumeration can be done endlessly, the main thing is to understand that it is better to exclude these factors from the mother’s life if possible, because for her the most important task is the birth of a strong and healthy baby, and the rest fades into the background.

However, excessive care and fear about future births can often do much more harm to the fetus and mother, so please do not turn into a “fanatical pregnant woman” when a woman begins to see some kind of negativity or resentment towards herself in any trifle.

What do the signs say?

The future mother’s love for life itself, for the people around her, and simply for herself will bring much more benefit to the child and her than everything inexplicable and having nothing to do with pregnancy, including all sorts of folk superstitions and for pregnant women.

Let's consider the most popular of them, which allegedly can cause a difficult pregnancy and abnormal development of the fetus:

• pregnant you can't knit because the baby may become entangled in the umbilical cord;
• pregnant you can't raise your hands high, because the child may begin to actively move and become entangled in the umbilical cord;
• A pregnant woman should not lie on her back because the baby may suffocate;
• pregnant women You can't refuse any food they ask for., otherwise she will have a difficult birth, and the child will have a deficiency in this particular food and a lack of attention;
• pregnant women you can’t take pictures and depict them on canvas, otherwise the child’s development may stop and freeze, as in a photo or portrait;
• pregnant You can’t look at scary things, disabled people and generally everything ugly, because the child will be born ugly, and the pregnancy will proceed inharmoniously;
• pregnant Do not untangle tangles, ropes, chains, because there is a possibility that the baby will become entangled in the umbilical cord.

What is the umbilical cord and what is its main function?

Under the term umbilical cord refers to a thin connecting organ between the fetus and the mother, which, in principle, exists only during pregnancy.

It consists of 3 main vessels:

1. Two arteries- through them, metabolic products saturated with carbon dioxide are removed with the mother’s venous blood;
2. Vein— ensures a uniform supply to the fetus through the mother’s arterial blood of all that is most beneficial for life: basic nutrients and vitamins, salts, minerals and oxygen.

The structure of the umbilical cord resembles a wire with a diameter of about 15 mm, with a spiral arrangement of vessels inside it, which painlessly straighten and stretch, thereby in no way interfering with the normal functioning of blood flow through the arteries and veins.

After birth, the most important wiring is cut, and with the first breath, the baby begins its life activities using its own circulatory system. Only the navel will further remind of this once very close connection between the child and the mother.

Causes of umbilical cord entanglement

Is entanglement in the umbilical cord dangerous, and what does it mean? This process considered quite common and unpredictable in medical practice, according to statistics, occurs in 20-25% pregnant women.

Most common species entanglements – around the fetal neck, cases of entanglement of limbs are less common.

The length of the umbilical cord cannot be predicted in any way; it takes on its dimensions according to genetic data, but, as a rule, it is the long umbilical cord that most likely wraps around the fetus.

The reasons for the formation of knots and entanglement of the umbilical cord are as follows:

1. main factor- excessive mobility of the fetus inside the uterus, which is often caused by intrauterine oxygen deficiency, called, or excess adrenaline contained in the mother’s blood. The latter arises due to frequent stressful situations, or because of a negative attitude towards extreme sports.
2. The expectant mother also activates the fetus, giving a lot of opportunities to make more movements inside the uterus.

The entanglement of the fetus with the umbilical cord is detected already from the 17th pregnancy during an ultrasound examination.

If an entanglement is detected, the attending physician will prescribe you:

1. undergoing a Doppler procedure, which will check the intensity of blood flow through the vessels of the umbilical cord;
2. a study that determines the fetal heart rate, which will reveal the sufficiency of oxygen.

Let's talk about the consequences

What to do if the umbilical cord is entangled, how to avoid it? If an ultrasound showed entanglement, then almost many gynecologists immediately try to dispel all the fears of pregnant women by saying that there is nothing dangerous to the life of the fetus in this, especially if the umbilical cord is wrapped around the neck only once(single).

Theoretically, the fetus, playing like a ribbon, can wrap itself around the umbilical cord many times throughout the entire period of time, even within an hour. And thus he can take the starting position as many times and swim happily without an umbilical cord around him.

But the determining risk factor is the size of the umbilical cord, namely its length. If she has minimum dimensions, then the consequences are dangerous, more risky with double(double) entwining of the umbilical cord around the neck.

How is it possible get rid of from such a seemingly harmless, but at the same time disturbing fact as entanglement with the umbilical cord?

Firstly, you, as a future mother, should always talk with your baby; regarding entanglement, you can also discuss with him all the consequences and persuade him not to be naughty. Gently and with great love and sensuality, explain to the child that this is good, first of all, for him, and, of course, for you.

Secondly, you must strictly listen to the advice of your doctor, undergo all examinations and follow the required recommendations.

During childbirth entanglement with the umbilical cord can provoke a variety of consequences; qualifications and experience decide a lot here medical personnel giving birth.

It is worth noting that the entanglement may be false, due to the human factor of the examining specialist during the ultrasound and the slight inaccuracy of what was seen on the screen. It’s just that the umbilical cord can fold such an intricate knot that what you see will look like an obvious entanglement.

Even if it is not false, but true, the child most often does not experience serious consequences after birth.

One of the hard ones is birth asphyxia, which in the future threatens with terrible diagnoses that combine both mental and mental retardation in the child’s development.

Less common and intrauterine circulatory disorders in the fetus, the consequences of which are a short umbilical cord.

I would like to finally tell expectant mothers that under no circumstances no need to worry about trifles and try to be on positive wave, leaving all the troubles of everyday life in the background. After all, all this is nothing compared to the emerging new life inside you.

Remember, while you are pregnant, all the forces of nature are on your side, and the umbilical cord, like Ariadne’s thread for Theseus, helps the baby survive until he takes his first breath.

The entanglement of the umbilical cord around the fetal neck is a complication that occurs during pregnancy, which can pose a threat to the normal development of the unborn baby. However, there is no need to immediately panic, since according to statistics, complications occur in only 10% of women in labor. When identifying this pathology, it is important that the expectant mother closely monitors her well-being and follows the doctor’s recommendations. Then the delivery will take place without complications and a healthy baby will be born.

The umbilical cord and its role in the development of the unborn baby

The umbilical cord is a temporary organ that is formed during pregnancy to ensure the connection between the body of a woman and a child. The umbilical cord begins to function at the 14th week of pregnancy. The shape of the organ resembles a rope, which is why it is also called the “umbilical cord.” The thickness of the umbilical cord is 1.5–2 cm. Inside the cord, as a rule, there are two umbilical arteries and one vein. To avoid compression of blood vessels, the umbilical cord cavity is filled with a substance whose consistency is similar to jelly (Wartoni jelly).
The umbilical cord delivers oxygen and nutrients necessary for normal development to the baby.

From the bloodstream of the expectant mother, through the placenta and further along the umbilical vein, oxygen and nutrients are delivered to the baby, which are necessary for its normal development. Recycled and unnecessary substances enter the woman’s body through the umbilical arteries.

The length of the cord should be 40–60 cm. With an increase to 70 cm or more, there is an increased risk of entanglement of the fetus.

It has been established that the length of the vessels is genetically determined, that is, the expectant mother is connected to her baby with an umbilical cord of the same length as she herself was connected to her mother. However, if the length of the vessels increases (more often this also depends on genes), we may encounter the problem of a “long umbilical cord” (more than 70 cm), one of the complications of which is entanglement of parts of the fetus and the formation of nodes.

Natalya Chukareva, obstetrician-gynecologist

Types of umbilical cord entanglement

The entanglement is divided into:

• false. The cord only lies on the future baby’s neck on one side;
• true. The cord is completely twisted around the fetal neck.

False entanglement does not pose a threat to the fetus, but true entanglement can lead to the development of complications, and therefore requires more careful dynamic monitoring of the woman.

In the medical literature, several classifications have been identified, which are based on what part of the fetus is entwined with the umbilical cord and how many times.

Based on the number of entanglements, they are distinguished:

• one-time;
• multiple (two-, three-, four-fold).

With a single wrap, the umbilical cord is twisted around the baby's body once, with a double wrap - twice.

Depending on which part of the fruit is entwined, there are:

• isolated (only one part of the fruit is entwined, for example, the neck or leg) entanglement;
• combined (the cord twists around several parts of the fetal body, for example, around the neck and legs) entanglement.

Reasons for the development of pathology

Factors that can lead to the formation of pathology:

• intrauterine hypoxia (lack of oxygen);
• polyhydramnios;
• long umbilical cord;
• impact harmful substances;
• frequent stress.

If the expectant mother does not follow a healthy lifestyle, spends little time walking in the fresh air or eats improperly, this can lead to her developing anemia. This condition in a pregnant woman will lead to a lack of oxygen in the fetus. As a result, the child will move much more actively, thus trying to inform the expectant mother about the existing problems. Active movements of the fetus can cause the umbilical cord to twist around its neck or other parts of the body.

With a lack of oxygen, the child begins to actively move and “gets entangled” in the umbilical cord

With polyhydramnios, the baby appears more space for movements, which can also lead to the development of this pathology.

Exposure to harmful substances stimulates work nervous system the fetus, which leads to an increase in its activity. Therefore, during pregnancy, doctors recommend:

• remove coffee and strong black tea from your diet;
• minimize exposure to occupational hazards (vibration, toxic substances: varnishes, paints, dust);
• to refuse from bad habits:
  • smoking;
  • drinking alcohol;
  • narcotic substances.

Stressful situations lead to the fact that the mother’s body produces a large amount of stress hormones, which also affect the baby. He begins to sense danger and moves more actively, becoming entangled around the cord.

Folk superstitions

The sign has been known since ancient times and states that pregnant women should not engage in needlework, since knitting, weaving, and sewing can lead to the child being entangled in the umbilical cord.
According to ancient superstition, knitting, weaving and sewing can cause the baby to become entangled in the umbilical cord.

As a person with medical education, I can say that needlework has nothing to do with this pathology. Superstition dates back to ancient times, when medicine was not sufficiently developed and there were no diagnostic methods such as ultrasound, Doppler, or cardiotocography, so it was not possible to track the condition of the fetus. People tried to explain the reason for the development of pathology and could not find an objective explanation, and since at that time most women were engaged in needlework, such a relationship arose. At the moment, medicine can name the reasons for entanglement, which are confirmed with the help modern methods diagnostics
There is another superstition that active movements of a pregnant woman (raising her arms up) can also cause the formation of this complication. Medicine completely rejects this sign, since the relationship between the raising of a pregnant woman’s arms and the umbilical cord entwining the baby has not been proven.
I believe that there is some truth in these words, but it is connected not only with the movement of the hands. Improper performance of gymnastic complexes and exercises active species Sports during pregnancy can lead to entanglement in the umbilical cord. However, this does not happen in all women, so superstition can only be attributed to factors that increase the risk of developing pathology, but do not lead to its formation in 100% of cases.

Symptoms of umbilical cord entanglement

The peculiarity of this pathology is that it can be asymptomatic and is detected only by ultrasound during a screening examination.

The only symptom by which an expectant mother may suspect that something is going wrong is fetal movements. Every child has a daily routine. Usually mom can tell what time he sleeps and what time he is awake. If the baby feels discomfort, the nature of motor activity changes.

If chronic hypoxia occurs, the child’s movements will be sluggish and rare. When a lack of oxygen occurs suddenly, the child experiences discomfort and begins to move actively. This is due to the fact that he tries to independently eliminate the cause of discomfort, and also reports the presence of problems.

Sudden hypoxia can cause placental abruption and premature birth, and in case of late diagnosis, the pathology leads to profound disability of the baby (especially in the mental sphere). In unfavorable cases, the fetus may die.

How to correctly count fetal movements

• Pearson;
• Sadowski;
• Cardiff.

All tests are based on counting the periods of fetal movements, which are noted in a special table placed in the pregnant woman’s exchange card, or in a regular notebook.

Normally, the baby should make at least 10 movements within 2 hours. If there are no movements at all within 12 hours, consult a doctor immediately.

The Pearson method is the most common because it is more informative and easier to use. Usually it is he who is presented in the pregnant woman’s exchange card.

Pearson method

A pregnant woman must monitor the baby's movements for 12 hours: from 9 am to 9 pm. One period of activity is taken as one movement (the child began to move and immediately made several movements). The next movement can be recorded only after a period of calm in the expectant mother’s stomach.

Counting is carried out until 10 motor periods are recorded. After 10 series of movements, it is necessary to note the time during which they occurred. If there are less than 10, you need to indicate the number of movements from 9 am to 9 pm that the mother felt and consult a doctor. You should immediately consult a doctor if no more than 3 periods of movement were observed per day.

Sadowski method

This technique involves counting fetal movements after eating in the period from 19:00 to 23:00. After dinner, the pregnant woman needs to lie on her left side and count all the baby’s movements, including pushes and rollovers, for one hour.

Over the course of an hour, a woman should normally count 10 movements. If there were fewer of them, you need to lie in this position for another hour, paying attention to the baby’s every movement. You should consult a doctor if there are less than 10 movements in 2 hours.

Cardiff method

The test according to the rules of conduct is similar to the Pearson method. The difference is that a woman can choose any time convenient for her to count fetal movements. Otherwise, the rules are the same: during 12 hours of observation, it is necessary to count the periods of fetal movements.

You need to see a doctor if there are less than 10 periods of activity in 12 hours. If the calculation result exceeds the specified data, this may be one of the symptoms of hypoxia. However, only a doctor can make an accurate diagnosis based on the results of ultrasound, Doppler and cardiotocography (CTG).

Diagnosis of entanglement of the fetal neck with the umbilical cord

To identify this pathology, use:

• ultrasound examination (ultrasound);
• Dopplerometry (measurement of blood flow in the mother-placenta-fetus system);
• cardiotocography (determining the fetal heart rate at rest and under the influence of external factors).

Ultrasound of a pregnant woman with umbilical cord entanglement in the fetus

Often, pathology is detected during routine screening of a pregnant woman. The examination can determine the presence of umbilical cord loops in areas of the child’s body. If an ultrasound visualizes the umbilical cord in the neck from all sides, an appropriate diagnosis is made. Other examinations are necessary to determine how much the pathology affects the development of the unborn baby. If results are obtained that are outside the normal range, the issue of further tactics for managing pregnancy and childbirth is decided individually.

Doppler

The study is aimed at determining the degree of circulatory impairment in the mother-placenta-fetus system. Using a special sensor, blood flow in the uteroplacental and umbilical vessels is determined. Reduced or increased indicators indicate the presence of problems in providing for the child nutrients and oxygen.
Doppler testing is aimed at determining the degree of circulatory impairment in the mother-placenta-fetus system

Table: norms of the uterine blood flow resistance index at different stages of pregnancy

Gestational age in weeks	Bottom line	Average	Upper indicator
20	0,37	0,52	0,70
21	0,36	0,51	0,69
22	0,36	0,50	0,68
23	0,36	0,50	0,68
24	0,35	0,50	0,67
25	0,35	0,49	0,66
26	0,35	0,49	0,65
27	0,34	0,48	0,64
28	0,34	0,48	0,64
29	0,34	0,47	0,63
30	0,34	0,46	0,62
31	0,34	0,46	0,61
32	0,34	0,45	0,61
33	0,34	0,45	0,59
34	0,34	0,45	0,59
35	0,33	0,45	0,58
36	0,33	0,44	0,58
37	0,33	0,44	0,57
38	0,33	0,44	0,57
39	0,33	0,43	0,57

Table: norms of umbilical cord blood flow resistance index at different stages of pregnancy

Gestational age in weeks	Bottom line	Average	Upper indicator
20	0,63	0,74	0,84
21	0,62	0,73	0,83
22	0,61	0,72	0,82
23	0,60	0,71	0,82
24	0,59	0,70	0,81
25	0,58	0,69	0,80
26	0,58	0,68	0,79
27	0,57	0,67	0,79
28	0,56	0,66	0,78
29	0,55	0,65	0,78
30	0,54	0,64	0,77
31	0,53	0,63	0,76
32	0,52	0,62	0,75
33	0,51	0,61	0,74
34	0,49	0,60	0,73
35	0,48	0,59	0,72
36	0,46	0,58	0,71
37	0,44	0,57	0,70
38	0,43	0,56	0,69
39	0,42	0,55	0,68
40	0,41	0,54	0,67

Cardiotocography

The diagnostic method allows you to determine how the umbilical cord entanglement affects the condition of the fetus. Each parameter is scored from 0 to 2 points.
To conduct the study, special sensors are attached to the belly of a pregnant woman and measure the main indicators of the fetus at rest, as well as when exposed to external factors.

Table: assessment of CTG indicators during pregnancy

To evaluate the result, the points received for each parameter must be summed up. As a result, the total can be from 0 to 12 points. Explanation of the results obtained:

• 9–12 points correspond to the normal development of the baby;
• 6–8 points indicate the initial degree of development of hypoxia in the child;
• less than 5 points indicate presence serious problems in fetal development.

Consequences of detecting entanglement of the umbilical cord around the fetal neck

If the pathology is detected on early stages pregnancy, there is no need to panic. Since the baby is still small and actively moving, it is possible that he will unravel on his own and by the time of birth there will be no entanglement.

I had a double entanglement with my first child and was prescribed to take a special metabolic course to improve blood flow, but by the time I was born the baby unraveled on its own, which I couldn’t describe how happy I was.

Katya Vasilenko

https://www.7ya.ru/article/Obvitie-pupoviny/

If the complication was detected at the 32nd week of pregnancy or later, dynamic monitoring of the fetus using cardiotocography is prescribed. When signs of severe hypoxia are observed, emergency surgical delivery (caesarean section) can be performed at any stage of pregnancy.

Negative consequences from the presence of this pathology can develop only if the problem is detected late, when the baby has suffered from a lack of oxygen for a long time. In this case, the unborn child may experience problems with the functioning of the nervous system, as well as mental retardation. If the baby does not suffer from hypoxia, there is no need to worry.

Prevention of pathology formation

To prevent the formation of entanglement of the fetus with the umbilical cord, a woman is recommended to:

• maintain the correct daily routine;
• reduce the impact of harmful and stressful factors;
• balance your diet;
• increase walks in the fresh air.

Prevention methods also include yoga, water aerobics and swimming. However, all exercises must be performed with a trainer and without excessive fanaticism.

What should an expectant mother do?

If a pathology is detected, a pregnant woman should more carefully monitor the baby’s activity and, if there are alarming symptoms, immediately consult a doctor. It is extremely important to follow all the doctor’s recommendations and under no circumstances ignore his prescriptions.

The pathology does not require drug treatment, but with initial signs of hypoxia in the fetus, to improve its well-being, the doctor can prescribe vitamin complexes and drugs to the expectant mother that improve blood flow in the mother-placenta-fetus system.

Doctors usually recommend increasing outdoor walks, balancing the diet, giving up bad habits (smoking, alcohol), if any, and eliminating exposure to stress factors.
You need to do water aerobics under the supervision of a trainer.

Breathing exercises, yoga and water aerobics may be recommended. The technique of performing breathing exercises should be shown by an experienced specialist, and yoga and water aerobics classes are best done under the supervision of a trainer.