Nuchal Umbilical Cord
            

A nuchal umbilical cord occurs when it becomes wrapped around an infant’s neck, which can cause birth asphyxia or deprivation of oxygen to the brain. Birth asphyxia can lead to more serious birth injuries for the infant such as cerebral palsy or hypoxic ischemic encephalopathy, which may be severely debilitating and can cause long-term disabilities. If you have an infant who has been diagnosed with one of these injuries, a nuchal cord may have caused it. You should contact a personal injury attorney specializing in birth injuries to consult if a medical professional’s negligence during delivery may be at play in your infant’s injuries. In Utah, Charles H. Thronson, Attorney at Law can provide you with years of experience in pursuing birth injury claims.

Birth Asphyxia due to Umbilical Cord

Normally, the umbilical cord is loosely coiled and is about twenty inches long. It essentially acts as an infant’s lifeline, delivering oxygenated, nutrient-rich blood to the infant in the womb and removes deoxygenated, depleted blood back to the placenta.  When the umbilical cord becomes wrapped around an infant’s neck, or cannot be undone and is knotted, this is called a nuchal umbilical cord. Nuchal cords occur 15 to 34 percent of all deliveries and may form at any time. Nuchal cords may disentangle on their own and later reform, or may persist until delivery. While it may not significantly affect a pregnancy, it can also cause a restriction of the infant’s neck artery if it is tightly entangled. It may also cause a compression of the umbilical cord’s blood vessels, thus restricting the flow of oxygen and nutrients. This may all lead to birth asphyxia.

Nuchal Umbilical Cords occur in 29 percent of deliveries after 42 weeks of gestation. It may be a random event or may be the result of excessive movement in the womb. There are certain risk factors that may also increase the likelihood of nuchal cords:

• • Infants with longer than normal umbilical cords;
• • Larger than average infants;
• • Moniamniotic twins, or twins that share the same amniotic sack;
• • Excess amniotic fluid around the infant; or
• • Breech or shoulder first presentation at delivery.

To diagnose the presence of a nuchal umbilical cord, medical professionals may conduct an obstetrical ultrasound to view the infant’s neck. Through an ultrasound, a physician may be able to see the cord encircling at least half of the infant’s neck, and ultrasounds are effective as a diagnostic tool up to 97 percent of the time, particularly with color Doppler ultrasound equipment. Additional, fetal heart monitors may detect decreased fetal activity or abnormal heart rates after the 37th week, which may also be an indicator of a nuchal umbilical cord.

Treatment of Nuchal Umbilical Cords

Preventing a nuchal umbilical cord from compressing during delivery is the primary goal. Course of treatment will depend on how tightly the cord is wrapped around an infant’s neck. If it is loose, it may be easily slipped over the infant’s head to decrease traction during delivery of the shoulders or body. If it is wrapped too tightly around the neck, then a doctor may be able to perform a somersault maneuver at delivery where he or she can deliver a baby with the cord unwrapped. At times, the doctor may have to resort to clamping the cord and cutting it before delivering the infant’s shoulders to ensure adequate oxygen supply. An emergency cesarean section may be necessary if labor is prolonged and is threatening the safety of the infant.

These are issues that arise during the delivery of an infant that a doctor and his or her medical team must be able to respond to appropriately using accepted medical standards. Failure to adequately monitor the infant, account for risk factors, and provide proper treatment for both the mother and the infant that results in birth injuries may constitute medical malpractice. Nuchal umbilical cords, if improperly treated, may result in birth asphyxiation and, eventually, more severe debilitating illnesses such as Cerebral Palsy.  Charles H. Thronson, Attorney at Law, is a seasoned advocate with years of experience in pursuing claims against medical professionals for birth injuries in Utah. If you believe medical professionals were negligent in providing you with care during your delivery, resulting in injuries to your infant, do not hesitate to contact us today for an initial consultation by calling (800) 532-0021 or by completing our online form. We will examine your case and advise you on your best course of action.