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Umbilical Cord Accidents and Stillbirth

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Updated May 07, 2009

Placenta

Most of the time, the likelihood of a cord accident is very low because the cord is well lubricated and resistant to compression -- but accidents can occur.

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The concept of umbilical cord accidents can be frightening even for women with no history of stillbirth. "Cord accident" sounds so random and so unpredictable, and it's natural to want to know more about what causes cord accidents and whether it's possible to prevent them.

What a Cord Accident Is:

The term "cord accident" is a general term for something having disrupted the blood flow to the baby through the cord. A cord accident might mean a true accident due to an entangled umbilical cord cutting off the baby's blood supply, or it might mean the cord failed because of medical factors. Cord accidents can be a cause of stillbirth.

Causes of Cord Accidents:

According to reproductive pathologist Carolyn Salafia, cord accidents can be random or occur after medical risk factors. Random cord "accidents" would involve one of the following:

  • Knot in the cord
  • Ruptured blood vessel in the cord
  • Prolapsed cord (umbilical cord begins to come through the cervix before the baby during labor)

But disruptions of the cord blood flow could also occur for other reasons, the most common causes of this would be:

Cord Accident Statistics:

The frequency of cord accidents is not truly known, but according to the March of Dimes, stillbirths occur approximately in 1 out of every 200 pregnancies and cord accidents contribute to between 2 and 4% of stillbirths, so they are relatively rare.

Why Cord Accidents Are Rare:

With all the kicking and acrobatics a baby does during pregnancy, you might wonder why cord accidents aren't more common. The answer is that a normal umbilical cord is thickly coated in a substance called Wharton's jelly. This makes the cord very slippery and protects against the cord being compressed by the normal movements of the baby -- and this is why having a medical condition that interferes with the normal functioning of the cord might theoretically increase the risk of a cord accident.

Preventing Cord Accidents:

Some cord accidents are random in nature and probably cannot be prevented, although sometimes if the problem is detected in time, doctors may be able to do something to boost the odds of the baby's survival, such as early delivery if the baby is in significant distress and past the age of viability. For this reason, it's important to notify your physician if you feel your baby is moving less than usual in late pregnancy -- although unfortunately, the majority of cases probably cannot be detected in advance.

Other cord accidents can occur after medical risk factors, such as having too little amniotic fluid, and doctors can sometimes pick up clues for these conditions during standard prenatal care, and then they can watch those pregnancies more closely. For this reason, attending prenatal appointments regularly will give your doctor the opportunity to detect problems early and may decrease the risk of stillbirth.

Although having a previous stillbirth is a risk factor for the subsequent pregnancy, researchers do not yet agree on the likelihood for a cord accident to happen again. One study by the Pregnancy Institute found that cord accidents could recur but there isn't much research on the matter. Regardless, it makes sense to see a doctor early along in a subsequent pregnancy after a stillbirth due to cord accident -- the doctor may consider the new pregnancy to be high risk and in need of additional monitoring.

Sources

Collins, Jason H., "Pregnancy after Stillbirth and Home Fetal Heart Rate Monitoring via the Internet." Pregnancy Institute. Accessed 11 Aug 2008.

March of Dimes, "Stillbirth." Quick Reference: Fact Sheets Apr 2008. Accessed 11 Aug 2008.

Salafia, Carolyn, "Cord Accidents." Early Path Medical Consultation Services 2004. Accessed 11 Aug 2008.

Terzidou, Vasso and Phillip Bennett, "Maternal Risk Factors for Fetal and Neonatal Brain Damage." Neonatology 2001. Accessed 11 Aug 2008.

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  6. Cord Accident - Umbilical Cord Accident as a Stillbirth Cause

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