Babies in the womb receive all of their nutrients and oxygen from the blood of the mother through the umbilical cord. However, if this crucial connection becomes compromised, the infant can suffer serious health complications, including a deprivation of oxygen and a disruption of proper growth. These issues can lead to additional birth injuries for the baby, including:
- Hypoxic ischemic encephalopathy
- Intrauterine growth restriction
- Seizure disorders
- Cerebral palsy
- Motor disorders
- Developmental delays
- Developmental and intellectual disabilities
Some common umbilical cord problems that can cause a baby to suffer restricted growth and/or oxygen deprivation are mentioned below:
Umbilical cord compression
When pressure hinders oxygenated blood from flowing through the umbilical cord, the condition of umbilical cord compression occurs. During the course of uterine contractions, it is common for small intermittent compressions to take place. However, if the umbilical cord is compressed more than normal, the baby can sustain brain damage as a result of oxygen deprivation, receive insufficient nutrition, or suffer fetal acidosis (too much CO2 in the baby’s blood).
Cord compression can occur due to several types of complications, including umbilical cord prolapse, nuchal cord, true knot, short umbilical cord, vasa previa, and inflamed or infected umbilical cord.
Umbilical cord prolapse
During a normal vaginal delivery, the infant first exits the cervix. The umbilical cord trails the baby through the birth canal. As a result of an umbilical cord prolapse, the cord moves down the birth canal prior to or alongside the infant. This can cause the cord to become compressed between the birth canal and the baby’s body. Due to the compression in the cord, the flow of oxygen to the baby may be restricted or cut off.
Nuchal cord (cord wrapped around the infant’s neck)
A nuchal cord occurs when the umbilical cord wraps around the neck of the baby at least one time, and sometimes multiple times. This is a somewhat common occurrence in pregnancies. At times the nuchal cord will resolve on its own. However, other times the condition persists until labor and delivery. It may also occur just prior to or during delivery. The baby is in danger of strangulation if the nuchal cord is wrapped too tightly around his or her neck. If the cord becomes compressed against the infant’s neck or against itself, the oxygen supply may be cut off. There are multiple ways in which a nuchal cord can prevent oxygen and blood flow through the umbilical cord and to the baby.
When the baby moves around in the womb, a knot can form in the umbilical cord referred to as a true knot. This condition is particularly dangerous when the umbilical cord is stretched due to the movement of the baby resulting in a tightening of the knot. As a consequence, the vessels in the quarter compressed, reducing the supply of oxygen to the baby.
Short umbilical cord
Although a long umbilical cord can put the baby’s health at risk, a short cord also poses multiple dangers to the infant. The major issue resulting from a short cord is placental abruption. This can happen when the movement of the baby leads to a partial or complete detachment of the umbilical cord and placenta from the uterus. This detachment causes bleeding during the baby’s delivery. A short cord is also at risk for rupture. These issues can significantly reduce or completely cut off the baby’s supply of oxygen.
Normally, the baby is connected to the placenta with fetal blood vessels traveling through the umbilical cord. When those fetal blood vessels travel outside of the protection of the umbilical cord and through the membranes positioned across the birth canal, the condition is referred to as vasa previa. In this condition, the fetal blood vessels lie across the birth canal opening, unprotected. There are two possible reasons for this condition:
- The placenta is split between two lobes
- Implantation of the umbilical cord has occurred in the fetal membranes rather than in the placenta
The danger to the baby involves significant blood loss if the unprotected fetal vessels rupture.
Inflamed or infected umbilical cord
At times, if the pregnant mother has one or more infections, they can also reach the umbilical cord, causing it to become infected and inflamed. One type of infection – chorioamnionitis – occurs when bacteria travels upward through the vagina into the uterus. This condition can cause infection and inflammation of the umbilical cord, which itself is referred to as funisitis. This condition of the umbilical cord can lead to oxygen deprivation for the baby. Both of these conditions – chorioamnionitis and funisitis – increase the possibility of premature labor and sepsis in the infant.