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Nuchal cords are a common occurrence during pregnancy. Most babies will not experience any permanent medical problems. In more serious situations, however, nuchal cord birth injuries can lead to severe impairment and disabilities, some of which include brain damage and cerebral palsy.
What is a nuchal cord birth injury?
A nuchal cord birth injury occurs when the umbilical cord becomes wrapped around a baby’s neck, causing medical problems. 
An umbilical cord, which connects an infant to a mother while inside the womb, has the ability to wrap itself around a baby’s neck in single, double, and more loops. It can be wrapped loosely, which makes it easier for doctors to slip over a baby’s head during delivery.
Tightly-wrapped nuchal cords can sometimes become impossible to slip over the baby’s head, which could call for emergency measures by medical professionals to ensure the baby doesn’t experience issues that can lead to long-term problems.
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How often do nuchal cord incidents happen?
According to the National Institutes of Health (NIH), the prevalence of nuchal cords is relatively high, happening in around 20% to 30% of pregnancies. However, in most instances, the nuchal cord is loose and the issue is resolved prior to childbirth or resolved during childbirth when the physician unwraps the cord from the baby’s neck. 
Expectant mothers shouldn’t be overly concerned if they notice a nuchal cord during an ultrasound, especially a loose nuchal cord.
When do nuchal cords become dangerous?
When a nuchal cord is wrapped too tight about a baby’s neck, there is generally cause for concern, especially if a physician doesn’t catch it in time and does not act quickly.
How can a doctor help if the nuchal cord is too tight?
If a baby has a locked and/or tight nuchal cord during the delivery, the physician may attempt a “somersault delivery” first before seeking out other options. A somersault delivery entails pushing the infant’s head to the side, toward the mother’s thigh, during vaginal delivery. 
Generally, a baby’s head would be pulled down during the delivery process, but pushing their head to the side allows the rest of the body to somersault out so that the cord isn’t tightened any further, allowing the doctor to unwrap the nuchal cord.
Somersault deliveries aren’t always successful. If the cord is left wrapped around the baby’s neck too long, serious consequences can occur. In turn, a physician may have to cut the umbilical sooner than recommended. Cutting an umbilical cord too soon comes may result in infant anemia.
If a doctor sees an infant is in distress, an emergency cesarean delivery may be carried out. 
What if the doctor doesn’t unwrap or cut the cord in time?
One of the most severe complications that can arise from nuchal cord birth injuries is, as mentioned earlier, brain damage. Lack of oxygen to the brain can occur when the umbilical cord is wrapped tight around the baby’s neck. This, in turn, can cause a host of additional medical problems, including:
- Developmental delays
- Intellectual disorders
- Motor disorders
- High fever
- Organ failure
- Heart abnormalities
- Meconium aspiration syndrome
- Infant death
Keep in mind that physicians have the legal responsibility to ensure that an infant is delivered as safely as possible. Birth injuries, however, occur each year at the hands of negligent medical experts.
Nuchal Cord Injuries and Cerebral Palsy
A 1994 study by the Department of Obstetrics and Gynecology at New Jersey Medical School and the University of Medicine and Dentistry of New Jersey Newark noted that at least five infants developed cerebral palsy when physicians cut the cords prior to birth. 
A lack of oxygen after birth due to umbilical cord issues can lead to cerebral palsy.
What are the Treatment Options?
The majority of nuchal cords are resolved after a doctor slips the cord off of the infant’s neck. Yet, should the baby suffer oxygen deprivation before the cord is removed, physicians may have to carry out treatment to reduce the chances of brain damage.
One of the most common treatment options for nuchal cord injuries is hypothermia therapy, also referred to as cooling therapy. Hypothermia therapy helps to reduce body temperatures on babies who were deprived of oxygen. Physicians may use a cooling cap to reduce the brain temperature to around 91 degrees Fahrenheit. Sometimes a cooling blanket is used.
Nuchal Cord Risk Factors
Per NIH, common risk factors of nuchal cords include:
- Excessive amniotic fluid 
- Poor cord structure
- Twins or multiples pregnancy
- Excessive fetal movement
- Long umbilical cord
“The incidence of all types of cord complications increases as the cord length increases. Nuchal cords had higher mean cord length than in cases without nuchal cords,” NIH wrote in a study carried out and published by J Obstet Gynaecol India.
“These cases had higher incidence of cord complications, increased incidence of operative interference, intrapartum complications, increased fetal heart rate abnormalities, and more chances of birth asphyxia,” the study added.
Maternal age, race, or weight prior to pregnancy does not play a role in the risk factors according to the NIH report. The sex and weight of the infant also have no bearing on the occurrence of nuchal cords.
Although there is no way to prevent a nuchal cord from happening, there are ways to prevent injuries, as long as physicians are competent and vigilant in detecting medical problems and concerns during pregnancy and childbirth. If you have concerns that your infant was not treated properly and in turn suffered injuries, please fill out our form above to locate leading birth injury attorneys in your area.
- International Brain Injury Association - IBIA. (n.d.). Brain Injury Research Community | International Brain Injury Association - IBIA.
Retrieved from: https://www.internationalbrain.org/articles/hypoxicischemic-brain-injury/
- Nuchal Cord and Its Implications. (n.d.). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719938/
- WF, M. (n.d.). Outcome of Infants Born with Nuchal Cords. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/1556538
- Study of Length of Umbilical Cord and Fetal Outcome: A Study of 1,000 Deliveries. (n.d.). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526711/
- Bernad ES , et al. (n.d.). Perinatal Outcome Associated with Nuchal Umbilical Cord. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23444751/
- Iffy L and Varadi V. (n.d.). Cerebral Palsy Following Cutting of the Nuchal Cord Before Delivery. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/7968307