The umbilical cord is a vital lifeline for the fetus. It ensures well being and proper development of the fetus. Yet it is vulnerable to various abnormalities such as torsion, kinking and compression. The umbilical cord develops as early as fifth week of pregnancy. Throughout pregnancy its function is to protect the vessels that travel from the placenta to the fetus. The cord has two arteries and one vein. One end of cord is attached to the placenta and other end is attached to the fetal abdomen. Nutrition and oxygen is carried to the fetus through the arteries and the solitary vein removes fetal waste.
A normal umbilical cord has many twists, approximately 0.2 twists in one centimeter of the cord. The umbilical cord is considered to have abnormal torsion when it is excessively coiled. This can compromise the blood flow to the fetus resulting in various fetal anomalies such as intrauterine growth retardation and sometimes death of the fetus.
Abnormal torsion can occur due to various reasons such as excessive length of cord, too much movement of fetus, and use of cocaine by pregnant women. A pregnant woman with abnormal torsion of umbilical cord needs close monitoring for better outcome.Treatment will depend on severity of the condition and stage of pregnancy.
Causes Of Umbilical Cord Torsion
Abnormal torsion of umbilical cord is a frequent occurrence in many pregnant women. At least 10 percent of pregnant women are known to have hypercoiling of the umbilical cord. It can occur at any age in a pregnant woman, but more often it is observed in woman with gestational diabetes, maternal age more than 35.
Excessive coiling can occur in pregnant woman having male or female child. However, it is more common if the fetus is male. Several risk factors have been noted to cause this abnormality. This includes excessive long umbilical cord, use of cocaine during pregnancy, increased fluid in the gestational sac and excessive fetal movement.
Symptoms Of Hypercoiled Umbilical Cord
The signs and symptoms of abnormal torsion of umbilical cord include following:
- Excessive coiling of the cord will result in pressure on the blood vessels. This will compromise blood flow to the fetus from placenta.
- When blood flow to the fetus gets restricted or become less it will cause fetal distress which may manifest as abnormal fetal rate.
- If thrombosis of the blood vessels occurs due to excessive twists and turns of the umbilical cord, it may result in excessive bleeding at the time of child birth.
- Reduced blood flow to the fetus increases possibility of retarded growth of fetus inside the uterus.
- Abnormal torsion is associated with increased mortality of fetus in the womb.
- Thrombosis of blood vessels of umbilical cord due to abnormal torsion can cause severe damage to the brain of the fetus. It may lead to cerebral palsy and damage to many organs of the newborn child.
Diagnosis And Treatment Of Umbilical Cord Torsion
The diagnosis of abnormal torsion of umbilical cord is made during the prenatal ultrasound test by the radiologist. Usually if abnormal torsion of umbilical cord is known, the doctor carefully monitors the pregnant woman from time to time as it is considered to be a high risk pregnancy.
If there is fetal distress noted, an elective cesarean section may be considered taking into consideration the pregnancy stage. There is no known method that can help to prevent abnormal torsion of umbilical cord. However, pregnant woman must not smoke, consume illicit drugs such as cocaine or consume alcohol during pregnancy.