In a study published by the National Institutes of Health, the Stillbirth Collaborative Research Network recently reported on the possible cause of death for 512 stillborn infants whose mothers gave consent for the postmortem exam. Umbilical cord accidents (UCA) accounted for 10% of the stillbirths in the study.
A review of the literature on stillbirths estimates that 15% might be caused by UCA. There are many different types of umbilical cord abnormalities, some of which can be identified in utero, but others are not apparent until the time of delivery.
Causes of umbilical cord complications
An umbilical cord accident or complication can describe something that has disrupted the blood flow from the mother to the baby through the cord. Cord accidents can be caused by a whole host of things such as:
- Knot in the cord
- Ruptured blood vessel in the cord
- Prolapsed cord
- Vasa previa
- Abnormal composition
- Cysts, hematomas and masses
The authors of the study recommend that Obstetricians and Gynecologists focus on screening for UCA, managing UCA prenatally and delivering the baby if it is in distress. They also recommended the use of ultrasound and MRI to visualize the cord, its placement and the characteristics of the cord’s placental and fetal attachments.
The study seems to be pointing out the fact that doctors should keep a closer eye on what is happening with the cord and listen more closely when the pregnant mother mentions certain symptoms, such as the baby hiccupping frequently after 28 weeks. This could be a clue that the fetal blood supply might be disturbed.
It is important for a woman to notify her doctor if she notices that her baby is moving a lot more than usual or a lot less than usual later in the pregnancy. If a doctor suspects an umbilical cord accident they should hospitalize the mother, do an ultrasound and monitor fetal heart rate for at least 24 hours.
There are many different causes for stillbirths and birth injuries; however, many can be detected in advance with proper screening and regular prenatal care. If an OB is not vigilant about screening for UCAs and a stillbirth occurs, the parents may be able to pursue a medical malpractice claim.