The umbilical cord is the link between the baby and the mother, and it is also an important channel for the mother and fetus to exchange gas, supply nutrients and excrete metabolites. However, the fetus is active in the mother's womb, which may lead to various umbilical cord abnormalities. Once the umbilical cord is abnormal, the fetus may have intrauterine hypoxia, embarrassment, suffocation or even death.
Today, Xia Yujuan, chief physician of the obstetrics department of Xuzhou Maternal and Child Health Hospital, took everyone to understand the common umbilical cord abnormalities, hoping to attract the attention of expectant mothers.
Abnormal umbilical cord length
Director Xia Yujuan introduced that the length of the normal umbilical cord is about 30-100 cm, less than 30 cm is too short of the umbilical cord, and more than 100 cm is too long of the umbilical cord. If the umbilical cord is too short, during childbirth, as the fetal presentation drops, the umbilical cord is stretched too tightly, which is easy to block the blood circulation of the fetus, resulting in hypoxia and abnormal fetal heart rate. If the umbilical cord is too long, it will cause the umbilical cord to become tangled and knotted.
The umbilical cord is knotted
There is a distinction between true and false umbilical cord knots. According to reports, umbilical cord pseudo-knot refers to the umbilical cord blood vessel is longer than the umbilical cord, and the blood vessel is curled like a knot, or because the umbilical vein is longer than the umbilical artery, the panel area forms a pseudo-knot. This pseudoknot usually doesn't have much effect on the fetus.
But the umbilical cord is really knotted! Most true knots are formed by the umbilical cord in the womb when the fetus is still small, and the fetus rolls and plays through these rings to form a true knot.
"True knots don't have much effect when labor doesn't start. However, if the umbilical cord is too short or when labor starts, the precarnation keeps falling, and the true knot becomes tighter and tighter, and the baby will have some accidents due to hypoxia. In such cases, the doctor will closely monitor the labor process and address the danger as soon as it occurs. Director Xia introduced.
Umbilical cord wrapping
"Umbilical cord entanglement is a very common phenomenon." Director Xia said, "Sometimes, newborn babies are like five flowers, some of them hold the umbilical cord by themselves, and some of them are wrapped around their bodies or necks, and various situations will occur. ”
What are the effects of umbilical cord wrapping? Director Xia said that it should be evaluated according to the location of the umbilical cord winding and the length of the umbilical cord. If the umbilical cord is long, even if it is wound a few times, it will not make much of a difference. However, if the umbilical cord is relatively short, even if it is wrapped for a week, it is dangerous for the fetus.
This requires pregnant mothers to pay attention to fetal movements, strengthen maternal and fetal monitoring, timely prenatal examinations, and choose hospitals with good medical conditions for treatment, and should be monitored 24 hours a day during labor. As soon as we find an anomaly, we will deal with it promptly. Director Xia reminded.
The umbilical cord is wrapped around the neck
During the prenatal check-up, the doctor usually tells the woman whether the umbilical cord is around the neck for a few weeks. This is because the B-ultrasound examination can clearly distinguish the number of turns of the umbilical cord around the neck, and the more the number of circles, the greater the impact on the baby. The umbilical cord around the neck needs to be evaluated by an obstetrician, according to the weight control of the expectant mother, pelvic conditions, fetal size, etc., to assess whether it can be delivered smoothly, if the conditions are good in all aspects, and the delivery can be carried out in a short time, even if there are 2 or 3 circles of the umbilical cord around the neck, it can also be delivered naturally. "At the same time, we will also do a good job of monitoring the whole process and closely observe the condition of the mother and fetus to ensure the safety of the mother and baby."
Umbilical cord presentation and umbilical cord prolapse
Umbilical cord presentation means that the umbilical cord is located in front of or on one side of the fetal presentation, and the fetal membranes are not broken, which is called umbilical cord presentation, and once the fetal membranes are ruptured, it is easy to develop into umbilical cord prolapse, also known as "occult umbilical cord prolapse". When the umbilical cord comes out of the vagina under the fetal presentation, enters the vagina through the cervix, and even exposes the vulva through the vagina, it is called umbilical cord prolapse. Umbilical cord prolapse can lead to umbilical cord compression, fetal blood supply disorder, easy to occur fetal intrauterine distress, fetal heart rate will disappear within 7-8 minutes, endangering fetal life.
In this case, if the uterine opening is fully opened, and the umbilical cord has prolapsed but the baby comes out immediately, the fetus can be delivered quickly using forceps. If the uterine opening is not fully opened and the fetal heart rate changes, at this time, the mother's buttocks should be raised, the fetus should be retreated, and the nearest cesarean section should be delivered in the shortest possible time, which can avoid the risk. "Therefore, it is recommended that women give birth in a regular hospital with the ability to rescue and dispose of it when they give birth."
Abnormal umbilical cord attachment
Normally, the umbilical cord attaches to the proximal center of the fetal surface of the placenta. The umbilical cord attaches to the edge of the placenta, which is called the racquet placenta, and the delivery process has no great impact on the mother and child, and most of them are found when the placenta is examined after delivery.
The umbilical cord attaches to the fetal membranes, and the umbilical cord blood vessels enter the placenta through the amniotic membrane and the chorion, which is called umbilical cord sail attachment. If the blood vessels on the fetal membranes cross the inner cervical orifice in front of the fetal presentation, it is called vasa previa, when the fetal membranes rupture, accompanied by the rupture and bleeding of the prevas, it can lead to fetal death, and if the prevasor is compressed, it can lead to obstruction of the blood flow of the umbilical cord, resulting in fetal distress or death.
Single umbilical artery
A single umbilical artery is a single umbilical vessel, and a normal umbilical artery is two arteries and one vein. The single umbilical artery is often one artery and one vein, which is an abnormality of a soft indicator. It is often accompanied by chromosomal aneuploidy abnormalities in the fetus and requires great attention.
What can pregnant mothers do to reduce their risk?
Although there are many types of umbilical cord abnormalities, pregnant mothers do not need to be anxious, let alone panic. To reduce the risk of umbilical cord abnormalities, Director Xia Yujuan suggests:
First, regular prenatal examination and re-examination of ultrasound: ultrasound examination is simple, fast and economical, and is the preliminary examination method for umbilical cord abnormalities.
Second, pay attention to fetal movements: every pregnant mother has her own fetal movement rules. If the umbilical cord abnormality causes intrauterine distress to the fetus, the fetal movement will change significantly, and the fetal movement will be excessive or reduced, and the patient should go to the hospital as soon as possible.
Third, try to choose a medical institution with better medical technology to ensure the safety of the mother and the fetus.
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Editor: Yao Meng
Reviewer: Xia Yujuan
Editor: Liu Yanmin