Umbilical Cord Compression

Definition - What does Umbilical Cord Compression mean?

Umbilical cord compression is a condition in which the lifeline of the baby called umbilical cord becomes squeezed by something pressing on it from outside or gets tangled and knotted. It affects roughly 10% of deliveries. Umbilical cord compression is more common during labor. However, it can also happen during the later stages of pregnancy when the baby becomes more active.

FertilitySmarts explains Umbilical Cord Compression

The umbilical cord is the route for vital nutrients and oxygen to the baby from the placenta and mother’s body. Mild cases of compression may not cause serious problems. But intense compression that lasts longer will cut off the oxygen and blood flow to the baby.

Various factors can contribute to umbilical cord compression such as:

  • Umbilical cord prolapse: The cord slips through the birth canal ahead of the presenting part (the leading part) of the baby. This can cause the cord to press between the baby and the mother’s birth canal.
  • Oligohydramnios (too little amniotic fluid, which is the fluid in the bag of waters surrounding the baby)— In addition to several important functions, amniotic fluid cushions the baby and the umbilical cord as well as prevents compression of the cord. A lack of amniotic fluid can thus lead to cord compression.
  • Polyhydramnios (too much amniotic fluid) can cause the water to break before time, known as premature rupture of membranes, which in turn, causes the cord to prolapse and compress.
  • Breech baby: The presenting part of the baby fails to engage in the mother’s pelvis, providing a lot of space for the cord to prolapse
  • Premature baby: These babies are at risk of umbilical cord prolapse, which in turn, causes cord compression.
  • Nuchal cord in which the umbilical cord becomes wrapped around the baby’s neck, tightening it, preventing the blood flow and causing the cord to compress.
  • A true knot tied in the umbilical cord can compress it if the knot becomes too tight. They are more likely to develop during early pregnancy when relatively more amniotic fluid is present and the baby is moving around briskly. True knots are also common in women with advancing age and long umbilical cords.

When umbilical cord compression occurs, the pregnant mother may notice the baby’s movements becoming a lot less frequent. Moreover, shortly after the water breaks, the mother may feel the cord dropping into the birth canal if it prolapses, and may even see it hanging down from the vagina.

Moreover, with umbilical cord compression, the baby’s heart rate will slow down suddenly, as detected on a fetal monitor by the doctor. The changes in heart rate will also cause changes in the baby’s blood pressure. When the umbilical cord remains compressed for a long time, there will be a decrease in blood flow and oxygen to the baby’s brain, further worsening the baby’s condition. In addition, carbon dioxide can build up in the baby’s blood making it too acidic. If not addressed in a timely manner, it will lead to shallow breathing and even death of the baby.

In mild cases, the doctor gives oxygen and fluids to the mother in order to maintain oxygen and nutrient delivery to the baby. For severe cases of umbilical cord prolapse, the baby shows signs of distress like continuously dropping heart rate, or if the mother’s water breaks, an emergency C-section will be necessary to save the baby.

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