Cord Compression - Mothering Forums

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Old 05-13-2009, 11:10 AM - Thread Starter
 
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A baby has a fine heart rate through labor until the pushing stage, then it plummets into the 60's. He his born with the cord around the neck and twisted around each leg. He is very blue and needs oxygen. He also had meconium that did not occur until pushing. The water had broken clear just as the mom felt the first urge to push.

The mom was in the typical hospital delivery position. Would change of position been able to release the tension on the cord when the baby is already in the born canal?
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Old 05-13-2009, 08:22 PM
 
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It's hard to do anything other than speculation, but I'd say probably not. The tension is mostly likely coming from the force of descent for birth making the cord tighter and tighter as the baby gets lower away from the cord insertion point, or as the baby rotates through the pelvis, not the pressure of the bony pelvis (which does get changed with different positions), like may happen with a cord prolapse.

HTH
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Old 05-16-2009, 10:20 AM
 
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I agree with CarolynnM to a point. I certainly agree that we can only speculate!

But in that situation, I would certainly have promoted changing positions til we found one that helped at least a little. Side-lying, H&K, upright--any of these may have helped at least a little. If birth is rapid, it doesn't matter as much--but still, a woman can roll pretty quick to sidelying.

But I'm a little confused here--in your thread title, you say 'cord compression', but in your post you mention 'releasing the tension on the cord'. THis is two different things as I see it--compression being the squeezing of the cord, by being caught between baby and pelvis as baby descends. Not sure how you meant it, but seeing the word 'tension on the cord' makes me image a cord pulled tight (around the neck in particular).

If the cord was pulling tight, I tend to agree more with CarolynnM...I don't konw as there is anything to be done about that. If it was more about compression, then position change may well have brought *some* relief. However, having seen a few well-wrapped babies like the one you describe, I think there is just no avoiding a degree of cord compression--again, you might affect some relief, but probably not total relief from compression.
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Old 05-16-2009, 01:22 PM
 
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Since hands and knees increases the pelvic outlet space by up to 30%, changing positions should help in a situation like this, provided that the pressure is coming from the pelvis and vaginal walls during descent. If the compression is due to a cord wrapping tighter because it has run out of length, then nothing but a speedy delivery will probably change anything. One of the few situations when I would consider purple pushing to do more good than harm.

Mom of three spunktastic kiddos, supported by super-partner while dabbling in midwifery and organic farming. Biting off more than I can chew since '03.
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Old 05-19-2009, 12:33 AM
 
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I agree too - position changes would be something that I would recommend intuitively, without thinking. Sometimes one position more than others seems to help relieve the pressure on the cord lying alongside the baby.
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Old 05-19-2009, 12:42 AM
 
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it surely could have helped. it would have been the first thing i would have tried. but one can only speculate if it definitely would have helped or not.

transtichel.gifMom of three - (2.5 yrs, 7yrs, and 11yrs). Birthing Doula, editor, and wife to my soulmate. I've had a c/s, hospital VBAC, UC and not yet decided what I'll do about this next little one

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Old 05-19-2009, 12:57 AM
 
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hard to say it was probably not the cord around the neck , nor was it probably the leg wraps but the lengths of cord that traveled down/up the torso that ties all the wraps together so that the trunk of the body was compressing the cord against the pelvis -- we had one baby who had a cord wrap that went under the arm and the arm pressed the cord against the body- so with great heart tones up to that point we ended up with a full resuscitation so the other componet is just how a baby's own reaction is -- another baby I saw with some fairly long dips and an ever lowering baseline- came out perfectly fine

might have tried another position and I may have mentioned it depends on if a mom is pushing in that fetal ejection reflex way or not how long was the pushing stage?
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Old 05-19-2009, 10:44 AM - Thread Starter
 
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The pushing stage was right at 20 minutes. It was an 11lber!

I used both the terms "cord compresssion" and "tension in the cord" because I can't say for sure what is was.

Thanks for the answers, they are very helpful!
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