About four weeks into a pregnancy, the umbilical cord starts to form. This connects the mother to the baby, who receives food and oxygen from the placenta through a vein in the cord. Two arteries in the cord carry waste from the fetus to the placenta. Around these three blood vessels is a protective substance known as Wharton’s jelly. Umbilical cord complications may arise during a pregnancy or during childbirth. They may emerge through an ultrasound of the womb, or they may not be discovered until the baby is born.
Most umbilical cord complications do not have severe or permanent effects, but some relatively rare complications may need to be addressed by doctors. In some cases, a doctor may recommend a C-section to protect the health of the baby.
Umbilical Cord Prolapse
Sometimes the umbilical cord enters the birth canal before the baby when childbirth starts. This can result in oxygen deprivation if the cord is squeezed. A mother may face a higher risk of this complication if they have a long umbilical cord, their baby is small or premature, the baby is in a breech position, or they are pregnant with twins or other multiples. Polyhydramnios (excessive amniotic fluid) also can increase the risk.
A doctor can identify umbilical cord prolapse by conducting a pelvic exam and checking the fetal heart rate. Sometimes they can fix this issue by changing the position of the baby. In other cases, a mother may need to give birth through a C-section.
Risk of Stillbirth
Failing to promptly address umbilical cord prolapse can cause stillbirth due to lack of oxygen.
Sometimes blood vessels from the umbilical cord or placenta may span the cervix, which is the opening from the uterus to the birth canal. This is an extremely rare condition known as vasa previa. During the early stages of childbirth, the blood vessels may tear because they are not shielded by either the placenta or the umbilical cord. Vasa previa is less well understood than umbilical cord prolapse, but risk factors may include a pregnancy with twins or other multiples, placenta previa, and an abnormal connection between the umbilical cord and the placenta.
A doctor may identify this condition through a pelvic exam or an ultrasound. When it occurs, vasa previa should be taken seriously because a baby can suffer severe and potentially fatal bleeding if the condition is not addressed. They may also develop complications from the pressure on these blood vessels. A doctor who diagnoses vasa previa may urge a mother to have a C-section.
Knots in the Umbilical Cord
Fetal movements during pregnancy can cause knots in umbilical cords. This may not affect fetal health, but a tight knot can cause oxygen deprivation and a risk of stillbirth or miscarriage. (Stillbirth is fetal death at or after 20 weeks of pregnancy, while miscarriage is fetal death before 20 weeks of pregnancy.) Risk factors include long umbilical cords and pregnancies involving identical twins. A doctor can identify a knot through an ultrasound and may recommend a C-section when this occurs.
Cysts in the Umbilical Cord
Sacs of fluid may form in the umbilical cord at any stage of a pregnancy. However, they are more common in the first trimester than later in pregnancy, and they likely will not cause problems if they are found in the first trimester.
Types of Cysts
Pseudocyst or false cyst: contains fluid from Wharton’s jelly and may indicate the presence of genetic conditions in the fetus
True cyst: contains fluid from the embryo and appears near the end of the umbilical cord that attaches to the fetus
A mother with an umbilical cord cyst may undergo genetic testing for birth defects, among other tests. A cyst may not pose problems, but a large cyst may spur a doctor to advise a C-section to prevent complications from the cyst potentially breaking.
A condition known as nuchal cord occurs when the umbilical cord wraps around the neck of the baby. A child usually does not suffer long-term problems from nuchal cord, although it can affect infant heart rate. Nuchal cord appears on ultrasound imaging, and a doctor generally can remove the cord from the neck without issues.
Compensation for Medical Errors Involving Umbilical Cord Complications
Most issues involving the umbilical cord can be identified and monitored or addressed. However, if a doctor fails to diagnose these complications through appropriate testing, or fails to follow up with a competent response, a fetus may suffer severe or even fatal consequences. This can be devastating for their parents as well. A family harmed by medical malpractice during pregnancy or childbirth should hold accountable any health care providers who were at fault. They may be able to get compensation for any medical expenses that they incurred, in addition to more intangible harm like pain and suffering.
The statute of limitations restricts the time for filing a birth injury lawsuit. Unless an exception applies, a court will dismiss a claim filed after the statute of limitations has expired, regardless of whether malpractice occurred. To preserve their legal rights, parents should consult a birth injury attorney as soon as they suspect that a doctor may have mishandled a pregnancy or labor and delivery. Some people worry about legal costs, but most attorneys offer free consultations at which they can explain the strength and value of a possible claim. If a family chooses to move forward, they likely will not need to pay attorney fees unless they receive compensation, part of which will be assigned to the attorney as their fee.