What is a nuchal cord?
Nuchal cord is the term used by medical professionals when your baby has their umbilical cord wrapped around their neck. This can occur during pregnancy, labor, or birth.
The umbilical cord is your baby’s life source. It gives them all the blood, oxygen, and nutrients that they need. Any problem with your baby’s umbilical cord can be very worrying, but the majority of nuchal cords aren’t dangerous in any way.
A nuchal cord is also extremely common, with around 1 in 3 babies being born perfectly healthily with the cord wrapped around their neck.
What causes a nuchal cord?
If you’re pregnant, you’ll know better than anyone how much babies move around in there! Baby acrobatics are a definite factor as to why they might end up with a nuchal cord, but there are a few other causes to be aware of, too.
Healthy cords are protected by a gelatinous, soft filling called Wharton’s jelly. The jelly is there to keep the cord knot-free so that your baby will be safe no matter how much they wriggle and flip themselves around. Some cords have insufficient Wharton’s jelly. That makes a nuchal cord more likely.
You may also be more likely to get a nuchal cord if:
- you’re having twins or multiples
- you have excessive amniotic fluid
- the cord is especially long
- the structure of the cord is poor
There’s no way to avoid a nuchal cord and they’re never caused by anything the mother has done.
Nuchal cords are hardly ever dangerous. If you do have one present, you probably won’t even hear it mentioned during your baby’s birth unless a complication arises. Babies can get the cord wrapped around their necks multiple times and still be completely fine.
Around 1 in 2,000 births will have a true knot in the cord, in which case there are some associated risks. Even in these cases, it’s rare for the cord to tighten enough to become dangerous. A nuchal cord that cuts off blood flow is life-threatening to the baby, however.
There are no obvious symptoms of a nuchal cord. There will be no change in your body or pregnancy symptoms. It’s impossible for a mother to tell if her baby has a nuchal cord.
Nuchal cords can only be diagnosed using an ultrasound, and even then, they can be very difficult to detect. Additionally, the ultrasound can only identify the nuchal cord. Healthcare providers can’t determine from an ultrasound if the nuchal cord poses any risk to your baby.
If you’re diagnosed with a nuchal cord early in the pregnancy, it’s important not to panic. The cord may unravel before birth. If it doesn’t, your baby can still be born safely. If your health professionals are aware of a potential nuchal cord during labor, they might suggest extra monitoring so that they can tell straight away if your baby develops any complications.
There’s no way to prevent or treat a nuchal cord. Nothing can be done about it until delivery. Health professionals check for a cord around the neck of every single baby born, and usually it’s as simple as gently slipping it off so that it doesn’t tighten around the baby’s neck once the baby has started to breathe.
If you have a nuchal cord diagnosed during pregnancy, there’s no further action to be taken. Your healthcare providers won’t suggest urgent delivery of the baby.
Any complication that arises from a nuchal cord is extremely rare. It’s important to manage your stress levels. Discuss any concerns with your healthcare provider so that they can help set your mind at ease.
The complication that occurs most commonly with nuchal cords arises during labor. The umbilical cord can become compressed during contractions. That reduces the amount of blood that’s pumped to your baby. This can lead to your baby’s heart rate decreasing.
With proper monitoring, your healthcare team will be able to detect this problem and, in the majority of cases, the baby is born without any complications from the nuchal cord. If your baby’s heart rate continues to drop and you’ve tried to labor in more effective positions, your care providers might suggest an emergency cesarean delivery.
In rare cases, a nuchal cord can also lead to decreased fetal movement, decreased development if it occurs early in the pregnancy, or a more complicated delivery.
In the majority of cases, a nuchal cord is in no way dangerous for mother or baby. In the rare cases where complications do occur, your healthcare team is more than equipped to cope with them. Babies are usually born safe and well following a nuchal cord complication.
It’s important to remember that nuchal cords can’t be prevented. There’s nothing a birth mother does to cause it to occur. If your baby’s been diagnosed with nuchal cord, it’s best to try not to worry about this condition. Added stress is not good for you or your baby. Speak with your healthcare provider if you have any concerns regarding your nuchal cord diagnosis.
Q&A: Nuchal cord and brain damage
Can a nuchal cord lead to brain damage?
A tight and persistent nuchal cord can cut off adequate blood flow to the brain and cause brain damage or even death during pregnancy. If the cord is around the neck at delivery, it can tighten as the baby moves down the birth canal. As soon as the head is delivered the healthcare professional will check for a cord around the neck and will slip it over the baby’s head. If the cord is very tight, it might be clamped twice and cut before the rest of the baby is delivered. There will be indications that the cord is tightening, including changes in the baby’s heart rate. If fetal distress is detected a cesarean section may be indicated.Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.