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Umbilical Cord Compression

This causes a brief interruption of blood flow to your baby.

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What is Umbilical Cord Compression?

During labor, the umbilical cord is sometimes stretched or compressed. This causes a brief interruption of blood flow to your baby, which can lead to a drop in your baby’s hear rate. Doctors call these heart rate drops “variable decelerations. If these occur frequently enough, or last too long, they can cause permanent, catastrophic injury to your baby.  

Many babies will periodically experience gentle, harmless umbilical compressions during pregnancy and labor. The compression on the umbilical cord, however, can occasionally be more severe and last for longer periods. When there is extreme compression that lasts for extended periods, it results in a reduction in the amount of oxygen and blood flow to your baby. The umbilical cord allows essential nutrients and oxygen to be transferred from you to your baby to the placenta, so extreme and extended compressions are serious.

 

Detecting Cord Compression

Fetal heart rate monitors are commonly used a mother’s labor. Using a sensor on the mother’s belly, these machines constantly monitor the baby’s heart and the mother’s uterine contractions. Using the graphs these machines create, helps doctors and nurses see how the baby is tolerating the labor process.  Below, you will see an example of a fetal heart rate and uterine contraction print out. 

heart-rate

As you can see, doctors and nurses and follow these patterns throughout the labor process. By matching up the lower uterine activity graph with the upper fetal heart rate graph, they can get a picture of how the baby’s heart rate is reacting to the “squeezing” of the uterine walls during labor. The baby in the graph above is doing fine, with a steady constant heart rate- even at the peak of uterine contraction. 

Now, take a look at this graph:

ECG

Can you see how each time the lower line peaks (the contraction) the upper line (fetal heart rate) drops? Something about each contraction is causing the baby’s heart to slow down. This could be a sign of umbilical cord compression, and it needs to be closely watched by the doctors and nurses.  Again, too much of this can cause the baby to suffer permanent catastrophic injury. 

If a doctor finds that the umbilical cord is being compressed too much during labor, action must be taken to lower the injury risk. Sometime, simple position changes for the mother can alleviate the problem. Other times, the baby must be delivered by c-section. 

Risk Factors

Umbilical cord compression may occur as a result of several factors, such as:

  • Multiple pregnancies (twins, triplets, etc.)
  • Unusual length of the umbilical cord (longer than 60 centimeters)
  • Excess amniotic fluid (hydramnios)
  • Birth trauma
  • Breech birth (where the baby descends through the birth canal bottom-first instead of head-first)
  • Premature birth

Dangers of Cord Compression

A cord compression can result in ischemia and hypoxia, two medical conditions that affect the baby. If the doctor can identify umbilical cord compression early enough, the baby should be delivered without any long-term effects. However, the baby could suffer serious and long-lasting harm if the doctor fails to recognize or treat the condition. Some long-term consequences include:

  • Behavior problems
  • Brain injury and related physical problems
  • Abnormalities in the fetal heart
  • Inadequate physical development

Cerebral Palsy

Umbilical cord compression can result in brain damage and, occasionally, cerebral palsy. Approximately 10,000 infants are born each year with cerebral palsy, but many of these cases are not identified until one to two years after birth. Stiff muscles, missed developmental milestones, floppy muscle tone, or abnormal movement are a few of the most common symptoms.

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Umbilical Cord Compression Treatment

Mild Compression

Doctors advise the following in cases of mild compression (where the infant appears to be in stable condition):

Administration of oxygen: Getting additional oxygen can help the baby's heart rate return to normal and stop any further compression.

Changing position: A change in the mother's position can occasionally relieve compression and increase blood flow to the fetus. 

Moderate Compression

Doctors may suggest the following course of action in moderate cases:

Intravenous (IV) fluids: Hydration through an IV can help feed the baby when compression slows down the delivery of nutrients.

Medication to stop contractions: A doctor may choose to delay contractions during labor. In some cases, this can alleviate umbilical cord compression and aid the baby's recovery before delivery.

Severe Compression

In severe cases, doctors may advise amnioinfusion if the amount of amniotic fluid is low. In this procedure, the uterine veins and arteries are opened using a saline solution. The doctor may also manually resolve a prolapsed cord. In other cases, a C-section may be required to save the baby's life if there are indications that it is in danger.

Medical Malpractice

Although umbilical cord compression is not unusual, it has the potential to cause fatalities, severe injuries, or irreversible brain damage. It is the responsibility of doctors and nurses who care for expectant mothers and assist with labor and delivery to recognize potential issues like cord compression and to provide care that complies with professional standards.

Birth Injury Attorneys in Maryland & Washington, D.C.

If you or your baby were harmed during your pregnancy or delivery, you may have a case for medical malpractice. The skilled attorneys at D’Amore Personal Injury Law will provide you with a free evaluation of your case and advise you of your legal rights. There are never any out-of-pocket costs to you unless they win your case. Reach out today at 410-324-2000 to schedule a free consultation.

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