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Nuchal Cord Complications Resulting in Birth Injuries

The birth of a child should be a moment filled with joy and wonder. Unfortunately, the experience brings back memories of fear, anger, and grief for some parents. Nuchal cords can result in birth complications, injuries, and, sadly, the baby's death.

Has your child suffered a birth injury to the negligence of others? The personal injury attorneys at Rosenfeld Injury Lawyers, LLC understand the heartbreak involved in a nuchal cord birth injury.

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Contact our birth injury lawyers at (888) 424-5757 (toll-free phone number) or use the contact form today for immediate legal advice and schedule a free consultation. All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.

What Is a Nuchal Cord?

A nuchal cord occurs when the umbilical cord becomes wrapped around the baby’s neck in utero. The term nuchal refers to the back of the baby’s neck. A nuchal cord injury can result in a poor fetal outcome.

The umbilical cord is the soft tube that connects the mother to the fetus. The umbilical cord connects the mother’s placenta to the fetus as the baby develops in the womb. Nutrients and oxygen are delivered to the baby via the umbilical cord throughout the pregnancy.

Umbilical cords have two arteries and one vein protected by a substance called Wharton’s jelly. Nutrients and oxygen are delivered to the baby via the vein, and then waste products and deoxygenated blood return to the placenta through the two arteries.

After birth, the baby’s umbilical cord is cut and clamped, leaving a stump that heals to form the baby’s belly button.

Research suggests that nuchal cord incidents are common and occur in up to 25% of pregnancies. However, birth injuries can occur if the umbilical cord becomes wrapped around the baby’s neck and disrupts oxygen flow to the fetus.

Nuchal Cord Birth Injuries

Nuchal cords can sometimes be detected on routine ultrasound scans during pregnancy. However, most nuchal cords are only discovered during the labor and birth of the baby.

There are two types of nuchal cords:

  • Type A- this is a loose nuchal cord that is free moving and has a high chance of unraveling from the baby’s neck on its own
  • Type B- this type of nuchal cord is generally wrapped around the baby’s neck, where the cord will not unravel naturally.

If a nuchal cord has been detected during an ultrasound scan, the medical professionals will monitor the growth and heart rate of the baby throughout the pregnancy. However, because the umbilical cord connects the mother and baby, there is no treatment available to deal with a nuchal cord in the mother’s womb.

The successful management of nuchal cords comes down to the doctor's skill at delivery. During contractions in labor, the nuchal cord may become compressed and reduce the flow of blood and oxygen through the blood vessels to the baby.

The fetal heart rate may show rapid deceleration during contractions due to the nuchal umbilical cord wrapped around the baby’s head. If the baby is showing signs of distress during the labor, a doctor may decide that a Cesarean section delivery may be safer for the baby’s health.

A lack of oxygen and blood flow to the baby can cause a birth injury. Brain damage, life-long development conditions such as Cerebral Palsy, and other disabilities are all common complications of a nuchal cord birth injury.

Tragically, some babies may die in utero, and the mother will suffer through the trauma of a stillbirth.

Risk Factors and Statistics

A recent study on the perinatal outcome of nuchal birth injuries found that nuchal cords caused up to 20% of stillbirths. In addition, 5% of infants born with nuchal cords required resuscitation at birth.

Many factors can contribute to the development of a nuchal cord:

  • Too much amniotic fluid in the uterus
  • Excessive fetal movement
  • A pregnancy involving multiple births
  • Weak connective tissue structure of the umbilical cord
  • An unusually long umbilical cord

According to the National Institutes of Health (NIH), maternal age, weight, or race do not increase the risk of a nuchal cord incident.

Most Common Umbilical Cord Problems

While most babies do not suffer a birth injury from nuchal cords, umbilical cord compression and other problems can present significant intrapartum complications. Nuchal cords can present in various ways, each with the potential to cause permanent injury to the baby.

Umbilical Cord Compression

Compression of the umbilical cord can cause a partial or complete loss of blood and oxygen to the baby. A nuchal cord can become compressed due to abnormal fetal movement during pregnancy or contractions in labor.

Symptoms of a compressed umbilical cord include:

  • Decreased fetal activity
  • Abnormal heartbeat observed during fetal monitoring
  • Poor growth of the baby in utero

True Knots

If the umbilical cord gets twisted and forms a knot, the condition is known as a ‘true’ knot.

Risk factors for true knots in the umbilical cord include:

  • Abnormal movement of the fetus in utero
  • High levels of amniotic fluid
  • Excessively long umbilical cord
  • A fetus that is smaller in size
  • Undergoing an amniocentesis (test to examine the amniotic fluid)

Umbilical Cord Prolapse

During vaginal delivery, the umbilical cord should follow the baby as it passes through the canal. If the cord prolapses and slips into the birth canal ahead of the baby, it can choke the fetus as they are birthed through the canal.

Umbilical cord prolapse can lead to birth asphyxia and poor fetal outcomes. Birth asphyxia occurs when the baby’s brain does not get sufficient oxygen before or during the birth. Unfortunately, this can occur undetected and lead to brain damage and conditions such as Cerebral Palsy.

If umbilical prolapse in the birth canal is suspected, medical professionals should monitor the condition closely and consider delivering the baby via C-section to avoid birth injuries from umbilical cord compression and constriction of the baby’s neck.

Short Umbilical Cords

A short umbilical cord can cause serious injury that threatens the life of both the mother and baby. If the baby’s umbilical cord is abnormally short, fetal movement may cause the umbilical cord to tear or damage the placenta.

Placental abruption may result in maternal hemorrhage (significant blood loss) that can be life-threatening. The mother may require a blood transfusion after delivery.

Vasa Previa

Vasa Previa is relatively rare, occurring in about 1 in 2500 deliveries. However, there is a 60% fetal mortality rate when Vasa Previa occurs if the condition is not detected before delivery.

Vasa Previa can be caused by placental abnormalities or velamentous cord insertion where the vessels from the umbilical cord are not protected by Wharton’s jelly, increasing the risk of fetal hemorrhage during delivery.

C-Section Pregnancies

If the doctor diagnoses a nuchal cord, the medical professionals should carefully monitor and manage the problem. Typically, the baby with a nuchal cord complication can still be delivered vaginally if the delivery team follows established maneuvers to help prevent severe complications.

A planned Cesarean section or emergency C-section is sometimes required to overcome the nuchal cord condition to prevent childbirth injuries. In addition, the obstetrician might attempt a 'somersault delivery' when the umbilical cord is wrapped too tightly to slip over the baby's head and shoulders.

Complications of a Tight Nuchal Cord or Other Nuchal Injuries

A nuchal umbilical cord can cause intrapartum complications that result in severe birth injuries. Nuchal cords can cause complications during pregnancy, such as poor fetal growth and heart rate abnormalities.

However, the most significant complications arise during labor and delivery if medical professionals fail to appropriately identify and manage the nuchal cord.

Common long term complications from a nuchal birth injury include:

  • Injury to the baby’s head
  • Seizures
  • Cerebral Palsy
  • Long term heart conditions
  • Brain damage
  • Developmental delays and intellectual disabilities
  • Death of the infant
  • Organ failure

Cerebral Palsy

Cerebral Palsy occurs when abnormal brain development or damage to the brain occurs, causing impaired functioning in the cerebrum and cerebellum. A lack of oxygen from nuchal cord birth injuries is a contributing factor to the development of the condition.

The disorder impacts body movement, coordination, and general functioning. Sadly, many children born with Cerebral Palsy will not be diagnosed with the condition until months or years after the delivery.

Treatment Options and Cooling Therapy for Nuchal Cord Injuries

Medical professionals should be skilled in identifying and managing nuchal cord conditions. Early identification and appropriate planning are crucial, such as opting for a C-section to avoid nuchal cord injuries.

However, if the baby does suffer a birth injury from nuchal cords during the delivery, cooling therapy may assist in treating and preventing the progression of the damage.

Cooling therapy involves placing the infant on a cooling blanket or fitting a cooling cap to the baby’s head. Cooling therapy and a cooling blanket are most effective if started within six hours after delivery and continued for several days.

Research suggests that cooling therapy can slow the progression of injuries caused by a lack of oxygen and blood flow to the brain during delivery.

Medical Malpractice and Nuchal Cords

Nuchal cord injuries can be avoided if medical professionals identify and manage the condition appropriately. Nuchal cords should be detected through prenatal scans and screening, and medical professionals should discuss a management plan.

Examples of medical malpractice may include:

  • Failing to identify a nuchal cord during an ultrasound or scan
  • Inadequate monitoring of the baby’s growth and vital signs
  • Not exploring birth options such as a C-section to avoid birth injuries
  • Failure to monitor the baby’s heart rate during delivery
  • Poor quality of care and attention during the delivery

How Do I Claim Compensation for a Nuchal Cord Injury?

If your child has suffered a nuchal cord injury, contact Rosenfeld Injury Lawyers, LLC at (888) 424-5757 (toll-free phone number) or use the contact form today for immediate legal advice and schedule a free consultation.

Our personal injury attorneys provide compassionate care and guidance throughout your injury claim and will fight to ensure that you receive compensation for any damages caused by negligence or misconduct.

We accept all cases on a contingency fee basis. This agreement ensures you pay nothing until your case is resolved through a negotiated settlement or jury trial award.

All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.

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