Umbilical cord complications
Cases of umbilical cord complications in pregnancy are numerous- some ranging from false knots, with no clinical significance to some which result in death. Due to the better medical tools available today, we can fathom such complications by scanning the uterus. However, many such symptoms may not be apparent before the delivery of the baby. This does not provide us with much of a forewarning and thus this article outlines the risk factors for known umbilical cord complications and the available courses of action to avert their associated morbidity and mortality.
Some of these risks listed below:-
- One needs to be wary of the cord length. The length may range from no cord or “according” to 300centimeters. The length of the cord is thought to reflect a movement of the foetus in the uterus. While short cords associated with foetal movements, disorders, and intrauterine constraint and are believed to result in placental abruption and cord rupture, excessively long umbilical cords related to foetal entanglement and knots.
- The risk of having a single umbilical artery. Single umbilical artery is believed to caused by atrophy of a previously normal artery, the presence of the original artery of the body stalk, or agenesis of one of the umbilical arteries. The prenatal diagnosis of a single umbilical artery should prompt examination for other anomalies as related anomalies can occur in any organ system, therefore, there is the need for a detailed anatomy survey whenever a 2-vessel cord discovered in a case of pregnancy. In such cases, a foetal echocardiogram may also be helpful.
- Velamentous insertion occurs in two cases –
(1) when the placental tissue grows laterally, thus leaving the centrally located umbilical cord in an area that becomes atrophic
(2) when the cord implants in the trophoblast anterior
Ultrasonography diagnoses a velamentous insertion and often associated with low birth weight, premature labour and abnormality in heart patterns during labour.
- Vasa Previa is another condition that occurs during when the foetal vessels in the membrane situated in front of the presenting part of the foetus. This may happen because of a velamentous insertion of the cord or with vessels running between the placenta and a suq centuriate lobe. This condition occurs in 1 per 2000-3000 deliveries. Though the cause of Vasa Previa is unknown, it may be associated with the low-lying placenta, placenta with accessory lobes, and with multiple pregnancies.
- Complications that occur in the form of cord knots, nuchal cord, and chord structure.
- Complications in the form of cord Hematoma, Cord Ulceration, Cord Cysts, and Cord Varix.
- Hemangiomas and Teratomas – Hemangiomas are masses that are predominantly found at the placental end of the cord while teratomas are rare germ cell tumours found anywhere on the cord.
- Cord Prolapse is a condition where the umbilical cord presents in front of the foetal presenting part and the membranes rupture, the risk that the cord will prolapse through the cervix into the vagina, is important. Cord prolapse occurs only in 0.6% of deliveries.
Keeping these risks in mind we realise how each pregnant patient is to be alert to any minute distress she may face and must immediately report to her doctor regarding the problem. Though ultrasound catches most of these complications of the umbilical cord, patients must be wary of how sometimes this may not be the case and it may become too late for any steps to taken medically.
Therefore, there is a need to take proper care and visit a gynaecologist and a prenatal doctor frequently to avoid any such mishap.