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An umbilical cord that is wrapped around a baby’s neck during labor is termed a nuchal cord, and if it is tightly wrapped it is called a tight nuchal cord. An umbilical cord that is wrapped around a baby’s neck is a common event, happening in about one third of all babies that are born.
The cord becomes wrapped around the baby’s neck as a result of moving around in the uterus during pregnancy. The cord may also be wrapped around the body, or it may circle the neck more than once.
A nuchal cord may be detected by ultrasound, or it may be visually diagnosed during delivery.
Usually the cord is loose enough for the caregiver to manually slip it back over the baby’s head to free them. The process may take a few minutes, particularly if the cord circles the neck a number of times. The mother will be asked to stop pushing while this is being done. A nuchal cord that is too tight to slip back over the baby’s head may need to be cut before the rest of the baby’s body can be delivered. Two cord clamps will be placed on the umbilical cord and the cord will be severed between them. A baby that has had the cord cut in this manner needs to be delivered quickly, as they are no longer receiving nutrients through the cord from the placenta. In rare cases the baby is coming so quickly that neither of the previous methods can be used. An experienced caregiver will hold the baby’s head close to the mother’s body during delivery, causing the baby be delivered through the cord, in a kind of somersault maneuver.
Extremely tight nuchal cords can cause hypoxia, or lack of oxygen to the brain, and decelerations of the baby’s heart rate. If the baby does not have enough oxygen over a period of time, the baby can suffer from brain damage.
After the baby is delivered and the cord taken care of in the usual manner, no further care required for a nuchal cord.