Umbilical Cord Around Neck: Risks and Implications

What is a Nuchal Cord?

An umbilical cord is a lifeline for a baby in the womb and is responsible for delivering all blood, nutrients, and oxygen to the baby from the placenta. It contains three umbilical vessels and is approximately 21 inches in length. Healthy nuchal cords are essential for healthy fetal development during pregnancy.

When an umbilical cord becomes wrapped around a baby’s neck, it is known as a nuchal cord. While the concept of an umbilical cord wrapped around the baby’s neck can be frightening, nuchal cords are very common and rarely dangerous. When a loose nuchal cord is wrapped around the baby’s neck, it typically poses little danger to the baby during pregnancy or delivery. In certain instances, however, a tight cord around the baby’s neck and head can become very dangerous to the baby during pregnancy or delivery by potentially cutting off blood and oxygen flow to the baby’s brain.

Nuchal cords are impossible to prevent. It is estimated that nuchal cords occur in 20-30% of pregnancies, often remaining undiscovered until the baby is born. There are many different causes of nuchal cords, including the following:

  • Regular fetal movement in utero;
  • Excess amounts of amniotic fluid allowing extra movement of the umbilical cord;
  • Extra-long umbilical cord allowing excessive twisting or knotting of the cord, leading to umbilical cord complications; or
  • Twins or multiple fetuses cause increased fetal movement in utero.

It is important to remember that nuchal cords are not caused by medical negligence. However, inadequate management or failure to recognize a delivery complicated by a nuchal cord may amount to medical negligence.

Nuchal Cord: Birth Injuries

Nuchal cords are most commonly discovered during routine ultrasounds or during labor and delivery. When a nuchal cord has been identified on an ultrasound prior to delivery, the doctors, nurses, and other medical professionals should closely monitor the progress of delivery to ensure there are no observable signs of fetal complication arising from the nuchal cord. This includes monitoring for signs of birth asphyxia, a serious condition that can occur if the baby’s oxygen supply is compromised.

Typically, nuchal cords that are loosely wrapped around the baby’s neck do not cause observable signs of fetal distress during labour. The cord can be slipped over the head and removed from the neck upon delivery. However, nuchal cords that are tightly wrapped around the baby’s neck, including instances of a tight nuchal or double nuchal cord, can cause interruptions of blood and oxygen flow to the baby’s brain by constricting the blood vessels, either in the cord or in the baby’s neck. This situation can result in fetal distress during delivery, including symptoms associated with tight nuchal cord petechiae. In cases of multiple nuchal cords, the risk of complications such as impaired fetal growth and heart rate abnormalities increases, potentially leading to a nuchal cord birth injury.

In some cases, a nuchal cord can become prolapsed. This happens when the umbilical cord falls in front of the baby’s head during delivery before the baby is born. When the umbilical cord prolapses, there is a significant risk of it being compressed between the baby’s head and the birth canal during contractions. A pinched or compressed umbilical cord can restrict blood flow and nutrients to the baby. This can have severe consequences for the baby and should be treated as a medical emergency. Pinched or compressed umbilical cords can be diagnosed through fetal monitoring during labour, and should be recognized by your doctors and nurses as a serious complication necessitating medical intervention.

Medical Malpractice in Nuchal Cord Injuries 

Nuchal cords are not preventable and are not caused by medical negligence. However, medical professionals have a responsibility to monitor and intervene if there is a danger to you or your baby’s health during delivery. Doctors, nurses, and other healthcare professionals are trained to recognize complications caused by nuchal cords during labour and delivery. Their timely interventions are crucial in preventing potential brain damage and serious injury to your baby. 

In cases where a nuchal cord is diagnosed prior to labor on an obstetrical ultrasound, medical professionals must monitor the progress of the labour and delivery vigilantly. This close monitoring is essential to promptly identify and treat any complications caused by the nuchal cord. Moreover, in cases where a nuchal cord develops during labour and delivery, medical practitioners have a responsibility to recognize the signs of fetal compromise and implement medical interventions to expedite delivery. 

Early recognition and intervention of nuchal cord complications during delivery is crucial to prevent fetal asphyxia. Undiagnosed and untreated nuchal cords can lead to severe outcomes with life-long consequences, such as hypoxic-ischemic encephalopathy, cerebral palsy, brain damage, and fetal death. Children who sustain serious injuries from nuchal cord complications often require lifelong care and support.

Suppose your child sustained a serious birth injury caused by negligent management of a nuchal cord. In that case, it is important to consult with an experienced medical malpractice lawyer to determine whether you have a viable claim of medical negligence. Consulting with an experienced legal professional can help you understand your options and assess if you have a valid claim for medical negligence. The dedicated team of medical malpractice lawyers at BIMMA have experience with birth injury cases and are ready to provide you with a no-obligation consultation to help you determine whether legal action is the right path for your family.