The umbilical cord circular: a danger for the baby? Answers from Grace B. Koumayi, Midwife

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Extract from the article: Umbilical cord circularity is an abnormality in the position of the umbilical cord as it wraps around the fetus. The wrapping is usually around the neck. The immediate threat is strangulation. According to statistics, one in three children is born wi

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Umbilical cord circularity is an abnormality in the position of the umbilical cord as it wraps around the fetus. The wrapping is usually around the neck. The immediate threat is strangulation. According to statistics, one in three children is born with the umbilical cord around the neck. In only 1% of cases does the cord exert pressure that could hinder the delivery process. It is also important to point out that if this happens, it is not necessarily a reason to perform a caesarean section. There are at least three techniques for dealing with this setback.

Pregnancy monitoring allows you to monitor the baby's heart rate during uterine contractions so that you can react quickly if you notice that the baby is in pain. Unfortunately monitoring is not available in some centres, so the midwife dealing with this situation will have to give an indication for a caesarean section (which is not good) but the most important thing is that both mother and baby are well and go home healthy.

Causes of umbilical cord circling

It is not uncommon for the umbilical cord to wrap around the neck of a foetus for two reasons: Some babies tend to play with it regularly, so there is a risk that it will gradually wrap around the legs, arms or neck. In the second case, the child can simply move around a lot in the womb (especially until the end of the first half of pregnancy, when it still has enough room) and thus drag the cord along with it in its acrobatics. Of course, over time, it will gradually wrap itself around different parts of its body.

A danger?

The fact that the umbilical cord is wrapped around the child's body does not represent a particular danger to the child's health or life. This condition is absolutely recurrent in the delivery rooms. Midwives and gynaecologists are therefore well trained to deal with it. It is usually possible at the time of the ultrasound to see if the cord is wrapped around the child's neck. The midwives or gynaecologists can thus see whether it is loose or not. And we repeat: A Caesarean section is not always necessary in this case.

Some methods used to remedy this situation in the delivery room

The simplest and most common procedure used in 90% of cases is for the midwife or gynaecologist to wait for the baby's head to emerge through the vaginal canal. Immediately afterwards, the birth attendant takes the cord and slides it over the head. In this way, the baby will be released.

The second type of procedure is reserved for 9% of cases. Here the birth attendant waits for the baby to come out completely and keeps it very close to the mother's crotch. At this point, he bends the baby slightly to slide the cord over her body. This technique is called the "cat sit-up".

The last type of procedure occurs in only 1% of cases. But it is the one that scares parents the most. Indeed, it has contributed to the persistence of myths about the dangers of the umbilical cord being wrapped around the baby's neck. If the midwife or gynaecologist detects that the cord is irreparably constricting the neck and compromising its oxygen supply, he or she will cut the cord in the vagina. This is done by inserting two hooks and then using scissors to cut it very carefully and release the baby.

Obviously, all measures to control this setback are in the hands of the midwives and gynaecologists. There is nothing concrete that the mother can do to avoid this condition.

Interview by Elom AKAKPO