Umbilical Cord Compression

During pregnancy and throughout labor and delivery, the umbilical cord provides the baby with life-giving blood, oxygen and vital nutrients. If the umbilical cord is compromised in any way, the baby’s health can be adversely affected. One of the most common things that can happen to this vital life-line is compression.

Umbilical Cord Compression Defined

When the cord is flattened due to pressure, the flow of blood and oxygen from mother to baby can be reduced or interrupted altogether. As a result, the infant can be vulnerable to serious and even life-threatening health risks that necessitate immediate detection and treatment.

Causes of Umbilical Cord Compression

This flattening can stem from a number of causes, the most common of which occurs when the baby lies on or otherwise presses on the cord while in the uterus. There are three main causes of umbilical cord compression:

  • Prolapse. In a conventional vaginal birth, a baby is born head-first, followed by its body and then the umbilical cord. A prolapse happens when the umbilical cord goes into the birth canal ahead of or at the same time as the baby. The cord is then compressed against the birth canal or the mother’s cervix. This type of compression occurs most often among women whose water broke before labor began.
  • Nuchal cord. This term refers to the compression that occurs when the cord is wrapped around the baby’s neck once or several times. If not corrected immediately, the baby can be deprived of blood and oxygen flow, resulting in serious health conditions.
  • Knotted cord. Also sometimes called a true knot, this condition occurs when the cord becomes kinked or knotted. If the knot gets tight enough, the cord can become compressed. This condition occurs more often during the earlier stages of pregnancy when the baby has more room to move in the uterus. Additionally, it is more common in older mothers who have had previous pregnancies.

There are also other causes of umbilical cord compression. For instance, it can occur in mild form during uterine contractions. It is also seen when the levels of amniotic fluid are low, a condition known as oligohydramnios.

Umbilical Compression Risk Factors

In many cases, umbilical cord compression occurs spontaneously without any prior indications that it might happen. However, there are some risk factors that medical treatment teams should be on the lookout for:

  • Premature delivery.
  • Breach delivery (when the baby is born feet-first.
  • Unusually long umbilical cord.
  • Twin birth.

Parents and their medical team should be aware of the risk factors and act proactively if the likelihood of umbilical cord compression appears high.

Umbilical Cord Compression Injuries

Although umbilical cord compression is usually detected and treated quickly and has a positive prognosis in those cases, it has the potential to cause severe complications and even fetal death. That is because depriving the baby of blood, oxygen and nutrients for any length of time can lead to severe consequences.

As soon as this condition is detected, the team must act decisively to restore the cord to its normal function. If the situation is overly prolonged, the baby could experience severe, life-altering complications including the following:

  • Brain damage.
  • Heart abnormalities.
  • Poor physical development.
  • Birth injuries after a required c-section such as fetal lacerations, bruising and swelling.

Cerebral Palsy

One of the consequences that can result from brain damage due to umbilical compression is cerebral palsy. This term refers to a series of motor disorders affecting movement, posture, motor control and balance. Anywhere between 8,000 and 10,000 people each year are diagnosed with cerebral palsy, which includes the subtypes of spastic, athetoid, ataxic or mixed varieties. The particular symptoms a baby displays depend on the type of cerebral palsy they have and may include floppy muscle tone, abnormal movements, paralysis, stiff muscles or the delayed attainment of developmental milestones. Although there is no cure for cerebral palsy and it will affect the baby throughout its life, a number of interventions are available that can treat and minimize the symptoms. The most common intervention types are physical therapy and pain medications. Because cerebral palsy affects everyone differently, it is important that families and their care team come up with a customized set of treatments to address their baby’s specific symptoms and situation.

Signs of umbilical Cord Compression

This condition is not always easy to discover, particularly when the baby is still in the womb. However, regular prenatal care that includes ultrasounds can be instrumental in detecting it. During these visits, doctors should be looking for the following warning signs:

  • Changes in the baby’s heart rate, often below 100 beats per minute. This can be picked up on a fetal monitor during labor and delivery.
  • Umbilical cord drop. There are instances when the mother feels the umbilical cord drop into the birth canal when her water breaks. This is the first sign of cord compression. It is important that the mother notifies her team immediately and that her doctor promptly acts to address her concerns.
  • Reduced fetal movement. Throughout pregnancy, mothers should pay attention to the activity of their baby. If these movements suddenly decrease in frequency, it could be a sign of umbilical cord compression.
  • Intrauterine growth restriction (IGR). During each ultrasound, your doctor will measure your baby’s growth. An umbilical cord compression could restrict the flow of nutrients to the fetus, resulting in restricted development.

Treating Umbilical Cord Compression

How umbilical cord compression is treated depends on the health of the mother and baby and what caused it in the first place as well as its severity. If the situation is minor, it sometimes can be corrected simply by changing the mother’s position. Saline solution can also be injected into the uterus in a process called amnioinfusion to reduce pressure and ease compression.

If the condition is moderate, the mother is usually given additional fluids and oxygen to push more of these substances to the baby. With the progression of labor, the medical team may elect to give the mother medications that will stop the contractions temporarily so that the baby can rest and recover.

In many instances, the umbilical cord compression fixes itself before causing severe effects to the infant. However, rapid reduction in the fetal heart rate after the mother’s water breaks requires immediate emergency intervention. In some instances, this necessitates an emergency c-section.

Prognosis for Umbilical Cord Compression

The outlook for umbilical cord compression is generally positive as long as the situation is addressed in a timely manner. Failure to obtain treatment, however, can lead to oxygen and nutrient deprivation or brain damage. In the most serious instances, babies can experience lifelong symptoms such as cerebral palsy, behavior disorders, autism and even fetal death.