Umbilical Cord Complications: Things You Didn’t Know About

During pregnancy, the umbilical cord is an emotional and physical connection between the mother and her baby. Some poets even take the poetic liberty to call the umbilical cord the string of life.

Undeniably, this cord is the route to love and nurture, while the baby is still in the womb. The umbilical cord structure allows the transfer of oxygen and nutrients from the maternal circulation, while simultaneously removing the waste products from the foetus. Therefore, whatever the baby needs for survival inside the womb reaches him or her via this cord. 

The Umbilical Cord Structure

The umbilical cord is a rope-like structure which is formed during the early phases of the embryonical development. It is a soft, tortuous cord with a smooth outer covering of the amnion. It has three blood vessels and one vein. It has a substance called Wharton’s jelly that keeps these blood vessels protected. The umbilical cord starts forming at about 4 weeks of pregnancy and the normal length of the umbilical cord is 50-60 cm.

Most of the time, during the prenatal doctor visits, a pregnant woman undergoes an ultrasound scan, where the doctor checks the umbilical cord conditions to check the baby’s growth. Rather, the doctor checks the umbilical cord complications. That further means, the doctor checks whether: 

There’s Velamentous Cord Insertion

Basically, in normal pregnancies, the umbilical cord attaches itself in the middle of the placental mass and is completely covered by the amniotic sac. However, in this kind of complication, the cord attaches itself in the foetal membranes without the Wharton’s Jelly, thus causing a loss of foetal blood. Such an instance in the umbilical cord is significantly high in vitro fertilisation (IVF), as compared to normal pregnancies. And this happens in about 20% IVF pregnancies and 10% normal pregnancies. 

There’s A Battledore Cord Insertion

Battledore means a tool with a long flat blade with a square end that is used in glass-working to flatten the bottoms of vessels. When the umbilical cord is attached to the placental margin, it is known as battledore cord insertion and that is reported in 7% of term pregnancies.

There’s a Marginal Cord Insertion

A marginal umbilical cord insertion occurs when the cord attaches on the side of the placenta instead of in the middle. In this case, the sides of the placenta are much weaker. They have less tissue as compared to the middle part of the placenta, where the cord is supposed to get attached. This condition occurs in 7.8% singleton pregnancies and 16.9 twin pregnancies, giving rise to pre-eclampsia in the expectant mother, pre-term birth and delivery by acute caesarean. Due to the presence of marginal cord insertion, birth defects in babies are also expected.

There’s Umbilical Cord Prolapse

In this condition, the umbilical cord slips into the vagina before the baby, at the time of birth and can get pinched. The baby’s oxygen also gets compromised leading to 

• pre-mature birth, 
• low birth weight, 
• breech position, 
• membrane rupture 
• too much of amniotic fluid 
• umbilical cord being too long  
• stillbirth (at times) 

An emergency c-section is usually performed in such cases.

There’s Single Umbilical Artery

Single umbilical artery, is when an artery is missing from the umbilical cord. 20% of the babies in this condition have heart, kidney and genetic problems. During an ultrasound, the doctor checks for the birth defect in babies.  

There’s Vasa Previa

In this condition, the cervix, which is the opening of the uterus is at the top of vagina. Since the umbilical cord or the placenta does not protect the blood vessels, they tear during the time of delivery, causing bleeding in the baby before birth with vasa previa. 

There’s A Nuchal Cord

Usually random movement of the baby inside the womb is one of the main reasons behind the nuchal cord. However, other factors might include the umbilical cord wrapping around the baby’s neck (due to an extra-long umbilical cord) or there’s extra amniotic fluid (which allows the baby to move around in the womb). According to the study of 2018, 12% deliveries had nuchal cord. Delivering a baby with such loops doesn’t involve many risks.

There Are Umbilical Cord Knots

This happens mostly when the umbilical cord is too long and the baby wraps it around his or her neck before birth. This condition also occurs when there are identical twins in pregnancy, who share the same amniotic sac and the cord gets entangled. 1 in 100 pregnancies undergo this condition. If the knot becomes very tight, the baby’s oxygen gets compromised, leading to miscarriage or stillbirth. An emergency c-section is necessitated during this condition.

There’s An Umbilical Cord Cyst

An umbilical cord cyst refers to any cystic lesion, or sac of fluid, on the umbilical cord. They have irregular shapes and may exist anywhere along the umbilical cord, generally between blood vessels. This condition is common in 1 out of 100 pregnancies. Single cyst may not cause any adverse effect to pregnancy or the developing baby, but multiple cysts are associated with increased risk of miscarriage, and foetal growth restriction.

What Are The Causes Of Such Complications?

Such complications in the umbilical cord are caused due to: 

• The length of the cord (long or short)
• When the cord is not connecting to the placenta properly and 
• When the cord is getting squeezed or knotted 

Cutting the Umbilical Cord

Once the baby is delivered, either vaginally or via C-section, the doctor checks the pulsating rhythm of the cord. Then the cord is disinfected and the vein is punctured to clamp and cut it a few inches apart, by placing a gauze under the section and using sterile scissors. This cutting of the umbilical cord after delivery, is absolutely harmless and painless.

Cord Blood Banking

Earlier, however, after the cord-cutting took place, it was a common practice to treat the cord as a medical waste. But, with the advent of science and stem cell therapy, it has been found out that, the cord blood is packed with enormous haematopoietic (blood-forming) stem cells, which has the capacity to differentiate itself into different blood cells, showing its potential in treating over 80 life-threatening diseases. So, after the birth of the baby, the caregiver collects the cord blood in a sterile bag to send it for quality testing, processing and cord blood banking.