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Is Loose Cord Around Neck Of Fetus A Cause For Concern?

Posted on Wed, 7 Jan 2015

Question: Hello -

My wife XXXXXXX (covered by the same policy that I hold) is 38 weeks 3 days pregnant. Based on the latest scan, her AFI is 20.0 and there is a mention of a loose cord around the neck. I have few questions based on this:

1. Is this considered normal? What are the things to watch out for in this scenario (both for the slightly increased AFI and for the cord around neck)?
2. Does this impact normal vs C-section delivery? How.
3. What is the chance the delivery can be normal - I hear the baby forms and comes out of the loop often. Should we take another scan to check the cord? If so, when can I do that?

FYI, the LMP is 26-Mar-2014 and the EDD is 02-Jan-2015.

Let me know if you have any questions before answering the above.

Thanks much for the response.

XXXX

Answered by Dr. Dr. Rakhi Tayal (27 minutes later)

Brief Answer:
Details below.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
1. A single loose loop of cord around the neck is not worrisome. It does not cause any fetal distress. Since your wife has already reached 37 weeks the increased liquor now cannot cause a preterm labor. So there is no need to worry now.
2. In case this is associated with a non reactive NST then the chances of C-section are increased. If she is feeling the baby movements normally then no need to worry. In case the liquor starts leaking before the pains start then she needs medicines to induce the pains.
3. The chances of a normal delivery are there. You can take another scan to see the loop of cord after the fluid starts leaking or the pains start.
In case there is no leaking or pains till 39 weeks then do consult your gynecologist for another NST.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rakhi Tayal (19 minutes later)

Thanks so much for your response doctor. On #2, please see attached the latest NST report for my wife. Is this report considered reactive or non-reactive? Please review and comment.

Also based on my understanding, during the time of labor, if the cord is still around the baby's neck, they will go for c-section else they would try normal delivery. Is that right? Please let me know. Also, are there other circumstances where a c-section is preferred over normal?

Finally, my wife has been complaining excessive back pain (which usually gets better with a back rub). Is this anything to worry about? She also mentions pains in lower back and lower front.

Thanks so much again.

Answered by Dr. Dr. Rakhi Tayal (8 minutes later)

Brief Answer:
NST is reactive.

Detailed Answer:
Hello.
Thanks for writing again.
NST you have attached is reactive. It is normal.
The C- section is done if it is a tight loop of cord or multiple loops are there. Single loose loop of cord easily slips over the baby's head and does not affect the normal delivery unless the cord is too small.
In case there are no pains or the cervix is not favorable or NST is non reactive even then C-section can be needed.
The lower back pain and in the pain lower abdomen are normal findings near the full tern. The pains in lower abdomen will gradually increase into labor pains. Do take rest in left lateral position. Avoid lying on the back to help it.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar