Diagnosis and handling of knotted umbilical cords

The article was consulted professionally by Specialist Doctor II Pham Thi Xuan Minh, Head of Obstetrics and Gynecology Department, Share99 Hai Phong International Health Hub.

According to statistics, the ratio of knotted umbilical cords accounts for 0.3 – 2.2% of pregnancies, and the mortality rate of fetuses experiencing this condition usually increases 4 times higher than that of a normal pregnancy. Therefore, knotted umbilical cords are a danger that "threatens" millions of pregnant mothers in our country and around the world. Identifying signs of knotted umbilical cords on ultrasound early will help pregnant women take timely response measures.

The umbilical cord plays an extremely important role, this is the path of oxygen and nutrients from mother to pregnancy, ensuring the baby grows healthy while in the womb. When the umbilical cord is tied into a knot will greatly affect the process of pregnancy and labor. When this happens, the fetus will not be provided with the necessary nutrients.

The knotted umbilical cord can be loosely tightened or tightened, the degree of danger will depend on the knotted state of the umbilical cord. If the tightening is loose, the pregnancy will be less affected, on the contrary, if the umbilical cord tightens, the fetal relapse will be hindered, the baby may die right in the womb.

It is difficult to determine the exact moment of formation or image of the knotted umbilical cord in the mother's pregnancy, since it is not always favorable for the image on the ultrasound machine. Knotted umbilical cord during pregnancy is difficult to detect, including through ultrasound and examination.

The umbilical cord ring can form very early, at which time the baby is only 9-12 weeks gestational. At this stage, the volume of amniotic fluid is more than the actual volume that the fetus occupies. It is very difficult to prevent the phenomenon of knotted umbilical cords, the mother can only diagnose the fetus experiencing the phenomenon of knotted umbilical cords by 4D ultrasound and in the first weeks of pregnancy. At this time the pregnancy is small and the umbilical cord is not long so the doctor can recognize it by identifying the umbilical cord is curled up. The larger the week of pregnancy, the longer the umbilical cord and the larger the baby, it is difficult to tell if the umbilical cord is curling or knotted.

The diagnosis of knotted umbilical cord relies primarily on color Doppler fetal ultrasound and 4D ultrasound when the umbilical cord flow rolls into a circle. It is necessary to distinguish from the false knotted umbilical cord due to the thickening of Wharton jelly or umbilical cord vascular edema, which does not pose any harm to the fetus during pregnancy and labor. In the later stages, through an ultrasound of the umbilical artery Doppler, the cerebral artery between the fetus and the fetal heart chart measurement can help detect complications of knotted umbilical cord and fetal failure for timely emergency.

To alleviate the dangerous complications of umbilical cord knots, women should monitor their pregnancy movement every day, especially in the last weeks of pregnancy, visiting to assess pregnancy health if signs of little or weak fetal movement are detected, the abdomen is risen, not round.

It is important to adhere to the scheduled pregnancy check-up on time, especially for pregnancies that are close to the date of birth. In case of luck, the maternity may feel abnormal and examined in a timely manner, the doctor correctly diagnoses the knotted umbilical cord and decides to have a quick caesarean section.

Once the knotted umbilical cord has been detected, there is no way to remove this knot, the treatment is now focused only on the safety of the fetus. Most cases have to be operated on as soon as possible before pregnancy failure occurs. If umbilical cord knots occur during labor, the fetus should be monitored, measuring the heart rate to detect abnormalities of the fetal heart rate. In most cases, the knotted umbilical cord needs to have a cesarean section, which cannot be born naturally because of the very high risk.

As can be seen, the knotted umbilical cord has no effective cure or prevention. Recognition through monitoring of pregnancy movement plays a decisive role in the emergency work of knotted umbilical cords. There have been many successful emergency cases of knotted umbilical cords but there are also countless unfortunate cases that occur, so pregnant women should not neglect, especially in the last months of pregnancy.

Share99 International Health Hub offers a full maternity care program for women from the very beginning of pregnancy from the first months with a full range of pregnancy examinations, 3D ultrasounds, 4D routines and routine tests to ensure the mother is always healthy and the fetus develops comprehensively.

Obstetrics and Gynecology will be consulted and checked under the close supervision of experienced and professional obstetrician, helping mothers have more knowledge to protect their health during pregnancy as well as minimize complications affecting mothers and children.