Pregnancy is often an exciting milestone for many women and their families. However, there are moments that could create a lot of anxiety and uncertainty during the course of the pregnancy.
One of those scary moments and the subject of many queries during prenatal clinics is the phenomenon of the umbilical cord wrapping around a baby's neck.
More than half of babies in the womb will have a cord around the neck at some point in the pregnancy but only 25 to 40 percent are born with it.
It all depends on the location of the baby as it moves in and out of the different loops of the umbilical cord.
So, how does the baby survive in the womb and does the cord impact the health of the baby?
Babies in the womb get their nutrients and oxygen from the mother through the placenta (also known as the afterbirth) via the umbilical cord.
The umbilical cord is on average 55 cm long, rope-like stricture that consists of three blood vessels along its length. The vessels are well protected with a slimy membrane and a jelly-like substance (Wharton's Jelly).
The vessels in the cord include one umbilical vein which pumps blood from the placenta to the baby and two umbilical arteries which drain blood from the baby back to the placenta.
In simple terms, the vein contains nutrient and oxygen-rich blood while the two arteries contain used blood with waste products.
The placenta acts as the main exchange organ between the mother and the baby. Babies therefore do not breathe while in the womb and there is no oxygen travelling down their throat to the lungs.
The first useful breath the baby takes is at birth. For this reason, it is not physiologically possible to strangulate or choke the baby to death while in the womb.
Let us assume for a moment that science is wrong and babies do indeed breathe in the womb through the windpipe.
If this were the case, then one would require a lot of force on both ends of the cord to strangulate the baby. Remember the cord is a jelly-like, slimy structure and the force required would have to be more than that of an ordinary rope.
Some mothers may, however, argue that they gave birth to a dead baby that had been strangulated by the cord as the cord was round the neck.
The truth is that this could just be a coincidence. As previously mentioned 25 to 40 per cent of women will give birth normally with the cord around the neck without having experienced a problem during pregnancy, or labour.
It is therefore not true that a cord around the neck can kill a baby, but it is very important that thorough investigations and autopsy are conducted to ascertain the cause of death and not to assume it was caused by the presence of a cord around the neck.
Generally, should you worry about your baby's umbilical cord around the neck?
Performing a scan at the late stages of pregnancy to ascertain whether the cord is around the neck is unnecessary and does not improve the outcomes of pregnancy.
There are more useful parameters such as the growth of the baby and the flow of blood through the brain and the umbilical cord that would inform us about the wellbeing of the baby.
Looking for the presence of an umbilical cord around the neck only creates a lot of anxiety for the mother and leads to inappropriate interventions in an otherwise healthy pregnancy.
Dr Wanyonyi, Consultant Obstetrician Gynaecologist and Foetal Medicine Specialist at Aga Khan University Hospital, Nairobi.
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