As a new or expecting parent, ensuring that your child is healthy and safe is one of your top priorities. You expect it to be among your doctor’s top priorities as well, and you expect this to translate to your doctor providing professional care at all stages of pregnancy, labor, and delivery.
When a baby is growing in the womb, the umbilical cord serves as its literal lifeline. As a result, ensuring the health of the umbilical cord is paramount to ensuring the baby’s health as well. The health of the umbilical cord should be carefully monitored throughout the mother’s pregnancy, and any concerns should be addressed immediately.
There are various umbilical cord issues that can potentially lead to severe complications. One of these issues is the compression of the cord. In this article, we will discuss the signs of umbilical cord compression, what causes umbilical cord compression, and what can (and should) be done to protect the fetus in the womb.
What Is Umbilical Cord Compression?
The umbilical cord serves two essential functions during pregnancy: It delivers nutrient-rich and oxygen-rich blood to the developing fetus, and it returns depleted blood to the placenta. While the umbilical cord is fairly simple in its makeup – consisting of two arteries, a single vein, protective Wharton’s jelly, and a protective outer membrane – its role during pregnancy could not be more important.
Due to the essential role that the umbilical cord plays in ensuring a healthy pregnancy and the fetus’s development in the womb, monitoring the health of the umbilical cord is just as important as monitoring the health of the fetus. As disruption of the fetus’s blood supply through the umbilical cord can have significant and permanent effects, compression of the umbilical cord is a risk that cannot be ignored.
When the umbilical cord is compressed, the squeezing of the arteries and vein in the cord can prevent the fetus from receiving the oxygen and nutrients that are essential to the fetus’s development. Just as oxygen and nutrients are essential to life outside of the womb, they are essential to life in the womb as well. Even a short disruption in a fetus’s blood supply can have significant consequences; and, if not addressed in a timely manner, compression of the umbilical cord can potentially result in stillbirth.
What Are the Signs of Umbilical Cord Compression?
As a result of the severe risks associated with umbilical cord compression, it is essential for doctors to be able to identify the signs of compression and provide appropriate treatment when necessary. According to the American Pregnancy Association (APA), “there are no visible signs of umbilical cord compression that can be seen without the help of a doctor.” The primary tools that are used to diagnose umbilical cord compression are:
- Ultrasound – Ultrasound imaging can be used to identify the location of the umbilical cord in the womb and determine whether the umbilical cord has prolapsed (fallen through the cervix) or may otherwise be at risk for compression.
- Fetal Doppler – A fetal Doppler is used to listen to the fetus’s heartbeat in the womb. Abnormalities in a fetus’s heartbeat can be symptomatic of various concerns, including an inadequate supply of oxygen resulting from compression of the umbilical cord.
Using ultrasound and fetal Doppler, doctors can identify the signs of umbilical cord compression during pregnancy and then determine what type of medical intervention is necessary. Signs of umbilical cord compression that may indicate fetal distress and the need for medical intervention include:
- Increased or decreased fetal movement
- Intrauterine growth restriction (IUGR)
- Abnormally fast heart rate (tachycardia)
- Abnormally slow heart rate (bradycardia)
- Late deceleration of heart rate following contractions
- Abnormally low amniotic fluid (oligohydramnios)
- Abnormally high amniotic fluid (polyhydramnios)
- Variable fetal heart rate
- Vaginal bleeding
Intrauterine growth restriction, tachycardia, bradycardia, oligohydramnios, and polyhydramnios are all potentially dangerous conditions that have their own unique symptom lists – and which can potentially lead to serious complications if not addressed promptly during pregnancy. Symptoms of these conditions that may also be indicative of umbilical cord compression include:
- Constipation or reduced urine output
- Difficulty breathing
- Enlarged vulva
- Swelling in the legs
- Unusual cramping or tightness in the stomach
- Premature rupture of membranes (PROM)
- Post-term gestation
- Fetal chromosomal abnormalities or malformations
However, it is important to note that these conditions are not necessarily associated with umbilical cord compression, and they can result from various other complications during pregnancy as well. With this in mind, an accurate diagnosis is critical. When these symptoms are present, doctors must carefully (but quickly) assess all potential causes in order to determine the appropriate course of treatment or intervention.
What Causes Umbilical Cord Compression?
There are three primary causes of umbilical cord compression, and each can potentially require a different medical response. As a result, once umbilical cord compression has been diagnosed, the next step is to determine what is causing the compression. The three primary causes of umbilical cord compression in the womb are:
- Nuchal Cord – Nuchal cord is a condition in which the umbilical cord wraps around the fetus. While an umbilical cord of average length (approximately 55 centimeters) is long enough to wrap around a fetus, umbilical cords of above-average length are particularly prone to compression due to this condition.
- Umbilical Cord Knots – As the fetus moves in the womb, it is possible for the umbilical cord to get tied into a knot. When this occurs, the tighter the knot gets pulled (due to the fetus’s continued movement), the greater the compression that can occur.
- Prolapse into the Cervix – The third primary cause of umbilical cord compression is prolapsing of the cord into the cervix. If a portion of the umbilical falls into the cervix, the opening of the cervix can compress the cord and limit or disrupt the supply of blood to the fetus.
With each of these causes, the severity of the risk to the fetus can vary greatly, depending on the extent to which the umbilical cord is compressed. In some cases, fetuses can continue to develop normally through all three trimesters. In others, emergency medical intervention may be necessary in order to save the fetus. Due to the broad range of potential risks and consequences, doctors must carefully evaluate each individual case of umbilical cord compression and provide treatment recommendations based upon the specific circumstances at hand.
What Can (and Should) Doctors Do to Prevent Complications from Umbilical Cord Compression?
What is necessary in terms of treatment or intervention in the case of umbilical cord compression is dependent on factors including the cause of the compression, the severity of the compression, and the number of weeks remaining in the mother’s pregnancy. Once umbilical cord compression has been diagnosed, a treatment decision needs to be made promptly, particularly if the compression presents an immediate risk for oxygen or nutrient deprivation.
Depending on the circumstances involved, treatment and intervention measures that may be necessary to prevent severe or fatal complications from umbilical cord compression include:
- Administration of Oxygen to the Mother – In less-severe cases of umbilical cord compression, administering oxygen to the mother may be sufficient to restore an adequate supply of oxygen to the fetus through the compressed cord.
- Amnioinfusion – Amnioinfusion is a form of treatment that involves introducing a saline solution into the mother’s uterus in order to alleviate pressure on the umbilical cord and open the arteries and vein inside.
- Careful Positioning and Monitoring – In some cases, the mother’s position (e.g., sitting as opposed to lying down) can place additional pressure on a compressed cord and limit the supply of oxygen to the fetus. When this is the case, determining the safest position and providing appropriate monitoring can protect the fetus and avoid the need for more-invasive intervention.
- Fixing a Nuchal Cord or Prolapsed Cord – Depending on the specific position of the umbilical cord, the stage of the mother’s pregnancy, and due consideration for other relevant risk factors, it may be possible for the mother’s doctor to manually resolve a nuchal cord or prolapsed cord.
- Emergency Cesarean Section (C-Section) Delivery – In severe cases, an emergency C-section delivery may be necessary to protect the fetus. When an emergency C-section is necessary, the decision must be made promptly, and the mother’s doctor must perform the procedure as soon as possible (in some cases, within minutes of the diagnosis).
What Are Your Family’s Legal Rights if Your Baby Suffered Complications due to Umbilical Cord Compression?
If your baby suffered complications due to umbilical cord compression, determining your family’s legal rights will require an assessment of what (if anything) your doctor could have done to protect your child. In most cases, there are steps that doctors can – and should – take to prevent complications resulting from nuchal, knotted, and prolapsed cords. If your doctor failed to conduct adequate diagnostic testing, if your doctor failed to provide treatment or intervene when necessary, or if your doctor made any other mistakes that led to your child’s condition, your family may have a claim for medical malpractice and you should consult with a dedicated injury lawyer promptly.
Some examples of conditions resulting from umbilical cord compression for which families will often be entitled to financial compensation include:
- Birth asphyxia
- Cerebral palsy (CP)
- Cognitive and behavioral disorders
- Developmental disabilities
- Fetal acidosis
- Hypoxic-ischemic encephalopathy (HIE)
Tragically, medical malpractice resulting in failure to timely address complications resulting from umbilical cord compression can also lead to stillbirth. If your baby did not survive, we offer our deepest sympathies, and we encourage you to speak with one of our lawyers about your family’s legal rights.
Speak with a Trusted Injury Lawyer at Berkowitz Hanna
If you would like more information about your family’s legal rights, please contact us to arrange a free and confidential consultation with one of our experienced attorneys. To schedule an appointment at your convenience, please call us directly or inquire online today.