Umbilical cord compression
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| Umbilical cord compression | |
|---|---|
| Synonyms | |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Fetal distress, decreased fetal movement, variable decelerations in fetal heart rate |
| Complications | Fetal hypoxia, acidosis, stillbirth |
| Onset | During pregnancy or labor |
| Duration | Variable |
| Types | N/A |
| Causes | Nuchal cord, true knot, cord prolapse, oligohydramnios |
| Risks | Multiple gestation, polyhydramnios, excessive fetal movement |
| Diagnosis | Cardiotocography, ultrasound |
| Differential diagnosis | Placental abruption, fetal growth restriction |
| Prevention | |
| Treatment | Intrauterine resuscitation, cesarean section |
| Medication | N/A |
| Prognosis | Depends on severity and duration of compression |
| Frequency | Common |
| Deaths | N/A |
Umbilical Cord Compression
Umbilical cord compression is a condition during pregnancy or labor where the umbilical cord becomes compressed, reducing or obstructing blood flow from the placenta to the fetus. This can lead to decreased oxygen and nutrient delivery to the fetus, potentially causing fetal distress.
Causes
Umbilical cord compression can occur due to several reasons:
- Nuchal cord: This occurs when the umbilical cord wraps around the fetus's neck.
- Cord prolapse: This happens when the umbilical cord slips ahead of the presenting part of the fetus during delivery.
- Oligohydramnios: A condition characterized by low amniotic fluid, which can increase the risk of cord compression.
- Knots in the umbilical cord: True knots can form in the umbilical cord, potentially leading to compression.
Symptoms and Diagnosis
Symptoms of umbilical cord compression may include:
- Abnormal fetal heart rate patterns, such as decelerations.
- Decreased fetal movement.
Diagnosis is typically made through fetal monitoring, which can detect changes in the fetal heart rate that suggest compression.
Management
Management of umbilical cord compression depends on the severity and timing:
- Repositioning the mother: Changing the mother's position can sometimes relieve pressure on the cord.
- Amnioinfusion: This procedure involves infusing saline into the amniotic sac to relieve pressure on the cord.
- Emergency delivery: In severe cases, an emergency cesarean section may be necessary to deliver the baby quickly.
Prognosis
The prognosis for umbilical cord compression varies. Mild cases may resolve without intervention, while severe cases can lead to complications such as hypoxia or cerebral palsy. Early detection and management are crucial to improving outcomes.
See also
References
- American College of Obstetricians and Gynecologists. "Umbilical Cord Accidents." Obstetrics & Gynecology, vol. 130, no. 2, 2017, pp. 1-5.
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Contributors: Prab R. Tumpati, MD