In the case of a nuchal cord, what should first be attempted?

Nuchal cord birth injuries are common during pregnancy. Most babies do not experience any permanent medical problems. In more serious situations, however, nuchal cord birth injuries can lead to severe impairment and disabilities, including brain damage and cerebral palsy.

What Is a Nuchal Cord Birth Injury?

A nuchal cord (or “cord coil”) birth injury occurs when the umbilical cord becomes wrapped around a baby’s neck. The umbilical cord connects an infant to its mother while inside the womb.

It can wrap itself around a baby’s neck in single, double, and more loops. It can be wrapped loosely, making it easier for doctors to slip over a baby’s head during delivery.

Tightly-wrapped nuchal cords can sometimes become impossible to slip over the baby’s head. This situation requires emergency measures to ensure the baby doesn’t experience issues that can lead to long-term problems.

How Common Are Nuchal Cord Incidents?

According to the National Institutes of Health (NIH), the prevalence of nuchal cords is relatively high, occurring in around 20% to 30% of pregnancies.

However, in most instances, the nuchal cord is loose and the issue is resolved prior to childbirth or resolved during childbirth when the physician unwraps the cord from the baby’s neck.[1]

Expectant mothers shouldn’t be overly concerned if they notice a nuchal cord during an ultrasound, especially a loose nuchal cord.

When Do Nuchal Cords Become Dangerous?

When a nuchal cord is wrapped too tight about a baby’s neck, there is generally cause for concern, especially if a physician doesn’t catch it in time and does not act quickly.

What Do Doctors Do to Manage Nuchal Cord?

If a baby has a locked or tight nuchal cord during the delivery, the physician may attempt a “somersault delivery” first before seeking other options. A somersault delivery entails pushing the infant’s head to the side, toward the mother’s thigh, during vaginal delivery.[2]

Generally, a baby’s head would be pulled down during the delivery process. Pushing their head to the side allows the rest of the body to somersault out so that the cord isn’t tightened any further, allowing the doctor to unwrap the nuchal cord.

Somersault deliveries aren’t always successful. If the cord is left wrapped around the baby’s neck too long, serious consequences can occur. A physician may have to cut the umbilical cord sooner than recommended. Cutting an umbilical cord too soon comes may result in infant anemia.

If a doctor sees an infant is in distress, they may perform an emergency C-section.[3]

What if the Doctor Doesn’t Unwrap or Cut the Cord in Time?

One of the most severe complications that can arise from nuchal cord birth injuries is brain damage.

Lack of oxygen to the brain can occur when the umbilical cord is wrapped tight around the baby’s neck. This, in turn, can cause a host of additional medical problems, including:

• Seizures
• Developmental delays
• Intellectual disorders
• Motor disorders
• High fever
• Organ failure
• Heart abnormalities
• Meconium aspiration syndrome
• Infant death

Keep in mind that physicians have the legal responsibility to ensure that an infant is delivered as safely as possible. Birth injuries, however, occur each year at the hands of negligent medical experts.

Nuchal Cord Injuries and Cerebral Palsy

A 1994 study by the Department of Obstetrics and Gynecology at New Jersey Medical School and the University of Medicine and Dentistry of New Jersey Newark noted that at least five infants developed cerebral palsy when physicians cut the cords before birth.[4]

A lack of oxygen after birth due to umbilical cord issues can lead to cerebral palsy.

What Are the Treatment Options?

Most nuchal cords are resolved after a doctor slips the cord off of the infant’s neck. Yet, should the baby suffer oxygen deprivation before the cord is removed, physicians may have to carry out treatment to reduce the chances of brain damage.

One of the most common treatment options for nuchal cord injuries is hypothermia therapy, also referred to as cooling therapy.

Hypothermia therapy helps to reduce body temperatures on babies who were deprived of oxygen. Physicians may use a cooling cap to reduce the brain temperature to around 91 degrees Fahrenheit. Sometimes a cooling blanket is used.

Nuchal Cord Risk Factors

Common risk factors of nuchal cords include:

• Excessive amniotic fluid[5]
• Poor cord structure
• Twins or multiples pregnancy
• Excessive fetal movement
• Long umbilical cord

“The incidence of all types of cord complications increases as the cord length increases. Nuchal cords had higher mean cord length than in cases without nuchal cords,” the NIH wrote in a study carried out and published by J Obstet Gynaecol India.

“These cases had higher incidence of cord complications, increased incidence of operative interference, intrapartum complications, increased fetal heart rate abnormalities, and more chances of birth asphyxia,” the study added.

According to the NIH report, maternal age, race, or weight prior to pregnancy are not risk factors. The sex and weight of the infant also have no bearing on the occurrence of nuchal cords.

Is a Nuchal Cord Injury Medical Malpractice?

Although there is no way to prevent a nuchal cord from happening, physicians should be able to prevent injuries and long-term damage. This requires monitoring and detecting medical problems and concerns during pregnancy and childbirth.

If you have concerns that your infant was not treated correctly and, in turn, suffered injuries, please fill out our form above to locate leading birth injury attorneys in your area.

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Identified risk factors for umbilical cord prolapse