"he had the cord wrapped around his neck and WOULD HAVE DIED!!" - Page 4

[Smokering]

I researched this during pregnancy, when the ultrasound tech noted at the 20-week scan that DS had a cord wrapped at least three times around his neck. My miidwife kinda freaked out and scheduled a second ultrasound for several weeks later, by which time DS was completely untangled (and I got an awesome ultrasound tech who spent the whole scan muttering about fear-mongering and too much information!).

There is a... thing... where the cord itself is improperly formed, and doesn't have enough Wharton's jelly in it. Wharton's jelly helps "insulate" the blood vessels against compression, so a cord with this deformity is much more prone to causing oxygen deprivation if it's pinched or kinked or otherwise stressed. So in those cases, it's not exactly the fault of the nuchal cord itself that causes issues, but the nuchal cord plus the cord malformation.

[DizzyDee2308]

@ Charmie

Recently a very large study was published (http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937811004807.pdf) that showed:

"the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality."

It was the largest study population used to date and says that previous studies were too small to show the benefit. I thought it was a fascinating study, and personally found it quite compelling.

[MamatoD]

Originally Posted by DizzyDee2308 

@ Charmie

Recently a very large study was published (http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937811004807.pdf) that showed:

"the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality."

It was the largest study population used to date and says that previous studies were too small to show the benefit. I thought it was a fascinating study, and personally found it quite compelling.

This study is not comparing EFM with intermittent auscultation (IA). This is comparing EFM to NO EFM.  Midwives use IA throughout labor which is shown to have as good of outcomes as EFM with a decreased rate of c-sections. Although this study is interesting and shows that EFM is better the no monitoring or inappropriate monitoring, I've seen it touted on a particular obstetrics blog as proving EFM is somehow better than IA, it's misleading to compare this to studies which were comparing IA to EFM such as the analysis which is available in the Cochrane Library, they aren't the same.

[Fulhouse]

I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend.  She was not in labor yet at all.

And this is a weird thing but I watched the special of the poor kidnapped and raped Jaycee Lee Dugard, who was forced to deliver her babies in a filthy backyard (at age 14) and only the sick pedophile Phillip Garrido was there to help.  Her first baby stopped coming after hours of labor.  So the creep reached in and unhooked the cord which was wrapped around her neck, and labor recommenced.  Who knows what would have happened if that sicko didn't for once do a good thing there?

I don't think the cord accidents , the fact that they do exist, mean people have to birth in a hospital.  it's just not a good argument.  A good doc or midwife at home could at least be as good as the sick creep Garrido.

[mmaramba]

I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend.  She was not in labor yet at all.

I'm so sorry for your friend's loss.  What about the tightly-wrapped cord caused her baby to die?

[savithny]

Originally Posted by mmaramba 

I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend.  She was not in labor yet at all.

I'm so sorry for your friend's loss.  What about the tightly-wrapped cord caused her baby to die?

You sound as if you doubt her story?  Why would you doubt her story?

Yes, its true that Whartons Jelly protects cords.

Yes, its true that "cord accident" is often used to explain stillbirth, without real confirmation.

Yes, its true that MOST cords around the neck do not kill babies.  Neither do true knots in cords.  The majority -- even the VAST majority -- of cords round body parts or knotted cords do NOT cause death.   

However: Compressing or kinking the umbilical cord for too long really can cut off the flow of blood and oxygen, and cause death.

They've watched babies in utero play with their own cords.  Sometimes they grab them and squeeze -- and their heart rate drops.  Of course, at that point they let go.  Cord compression really does have an immediate effect and can be dangerous.

And sometimes, a tightly wrapped cord really can kink or block off long enough to cause death.   

[GuildJenn]

Originally Posted by Fulhouse 

I hate to even add to this thread but yes, of course a baby can die in later pregnancy, even with no labor yet, by the cord wrapping too tightly around her neck. This happened to my friend.  She was not in labor yet at all.

And this is a weird thing but I watched the special of the poor kidnapped and raped Jaycee Lee Dugard, who was forced to deliver her babies in a filthy backyard (at age 14) and only the sick pedophile Phillip Garrido was there to help.  Her first baby stopped coming after hours of labor.  So the creep reached in and unhooked the cord which was wrapped around her neck, and labor recommenced.  Who knows what would have happened if that sicko didn't for once do a good thing there?

I don't think the cord accidents , the fact that they do exist, mean people have to birth in a hospital.  it's just not a good argument.  A good doc or midwife at home could at least be as good as the sick creep Garrido.

Okay look, my baby died due a cord accident - 2 x nuchal cord. What she needed was a c-section. A single loop is completely different than a double loop. It's also important how close to the placenta or navel the wrap is - many of them are fine but if the tension is tight, it's a problem.

In my case we did a full pathology on the cord and the placenta. The deal is that it was so tight against the placenta, I was pushing against the cord in labour - there was stress on the cord at its base due to the vaginal delivery, after which my daughter died (4 days later).  My daughter did not have enough oxygen because the cord was tight and bloodflow in the cord was restricted. Her heartrate stayed high, although its variability and when it recovered during a contraction were visible on the monitor. (The nurse, or rather "nurse" who was hell-bent on not letting one of 'her' patients have a c-section, decided it was tolerable until it was too late.)

By the way, we got her out BECAUSE the cord stretched - her heart had already stopped for some minutes - and even so the OB had to do a huge episiotomy...to cut the cord at her neck before the rest of her was birthed.

So sorry to kind of piggyback on your post but YES doctors can save babies from cord accidents - not all the time but they can. And for the love of God, I wish people would stop saying it can't happen when people like me have lost their kids to that issue.

It is exceedingly rare? Yes, it is. My next OB and I calculated the chances of all the various issues (cord, bad nurse, lots of people having c-sections that day) repeating being somewhere around 1:100,000 and the cord accident itself was a 1:1000 chance. However. It does happen.

[mambera]

Originally Posted by Charmie981 

Yes, it's important to note that the issue is not having something around the neck causing asphyxia (as it would when we're yelling at our kids "don't wrap that jump rope around your neck and run!"), but that cord tightly wrapped can cause cord compression, which can interfere with the flow of oxygenated blood from the placenta to the baby. Cord around the neck compresses more than cord around, say, the foot, just because there are more folds in the neck and the cord can be compressed between the neck and a shoulder.

Doesn't compression of the great vessels come into play here?  Sure the baby is not getting oxygen through his windpipe, but his brain still needs it to be delivered via his neck.  No?

[tireesix]

Last babe was born at home with no contraptions, midwife was late etc, dh wasn't there (he couldn't hear me shouting for hime any way), I aught babe, she had cord round her neck a coupla times, I simply unwound it and and got on with breastfeeding.

I guess problems can and do occur with cords but I think a lot of people freak out about it way too much.

[Plummeting]

Originally Posted by jeninejessica 

There's a large number of babies whose moms don't even know they had the cord around the neck because the dr just loops it over the head as the baby delivers. Most of the time it's no big deal.

Yes, I never would've known at all if my midwife (at the hospital) hadn't said, "Stop pushing for a minute, I have to unloop this cord." Then she counted out, "One, two, three times! We don't see that every day" or something like that. She also reassured me it was no big deal and everything was fine.

I do think that if the cord had been around my second dd's neck like that, it could've been very serious, as her cord was short and she was a precipitous labor (51 minutes from start to finish). There would've been no time for anyone to do anything about it if she'd been in distress. If it had been wrapped like that, I think it would've pulled too tightly. Obviously that's just conjecture, but I'm a very pro-natural birthing woman and I can definitely see how that could've been very serious. Her cord just wasn't long enough to wrap around her neck like that and still allow her to get out without too much stretching.

[mmaramba]

Originally Posted by savithny 

You sound as if you doubt her story?  Why would you doubt her story?

Yes, its true that Whartons Jelly protects cords.

Yes, its true that "cord accident" is often used to explain stillbirth, without real confirmation.

Yes, its true that MOST cords around the neck do not kill babies.  Neither do true knots in cords.  The majority -- even the VAST majority -- of cords round body parts or knotted cords do NOT cause death.   

However: Compressing or kinking the umbilical cord for too long really can cut off the flow of blood and oxygen, and cause death.

They've watched babies in utero play with their own cords.  Sometimes they grab them and squeeze -- and their heart rate drops.  Of course, at that point they let go.  Cord compression really does have an immediate effect and can be dangerous.

And sometimes, a tightly wrapped cord really can kink or block off long enough to cause death.   

Actually, no, it was not a matter of "doubt," but a sincere question.  I was trying to picture how a cord wrapped tightly around a baby's neck cuts off circulation or what-have-you.  It's not something I fully understand.  That is, I understand that cord compression can lead to death, and I also understand that nuchal cords usually do not cause death, so I was trying to understand why-- how, really-- some do.  What the "difference" is, or if anyone knows definitively.

[kittywitty]

I am sorry for all of the losses.

Two of my brothers were born with the cords around their necks- they were fine. I don't think any of my kids did. My hb and UC did not. But I have a dear friend who had a C-section last year after FTP after an induction. She just couldn't get him to descend. His cord was around his neck three times very tightly. It was fairly short, she said the doctor told her. So it definitely can happen. Most of the time it's not an issue, but it certainly does happen.

[loraxc]

My DD had a triple nuchal cord and a true knot and never decelerated during labor at all and was born pink and screaming. However, she was a 34-hour labor and a birth center-hopsital transfer. I dilated to 4 and stopped, for 12+ hours. I also pushed for more than 2 hours. So...one wonders. She was also posterior, though.

I surely would have been sectioned with an OB, but fortunately I did have a CNM who was able to continue care in the hospital and support my desire for a vaginal birth. I did end up with epi, tons of Pit, the whole 9 yards.

My second child was an easy-breezy 6-hour labor and homebirth, maybe 15 min of pushing. He had a nuchal hand but no nuchal cord or knot.