When an umbilical cord is straight, it’s termed as a hypo-coiling of the cord. It may represent a pathologic developmental process that places the fetus at risk. The absence of the typical coiled umbilical configuration may result in a cord that is structurally less able to resist external compressive forces. It’s been reported to be more frequent in females with gestational diabetes and preeclampsia. Early detection is done to these malformations of the umbilical cord to provide a proper diagnosis and plan of care. Seeking professional care and treatment is advised.
The umbilical cord is not only the lifeline to the fetus in a mother’s womb but also represents an emotional connection between both.
This cord is a bundle of vessels that develops during the early stages of embryological development. The twist in the cord has been observed as early as the sixth menstrual week and is considered an important developmental stage in pregnancy.
So what does it mean when this cord is straight? Does a straight umbilical cord harm your fetus’s health in any way? What causes the problem, and how can you treat it? Let’s find out.
What’s the importance of a coiled umbilical cord?
The standard coiled cord contained an umbilical vein and two umbilical arteries with Wharton’s jelly as the connective tissue.
Together with the placenta, it contributes to the flow and regulation of fetal circulation.
The coiling pattern develops during the second and third trimesters, possibly due to snarls in the cord, and this coiling changes as the pregnancy advances.
Usually, the umbilical cord coils to the left.
One of the typical morphological variations of the cord is its different helical coiling patterns. The term umbilical coiling index is vital in determining the intercoil distance in centimeters.
The degree of coiling is measured by the umbilical cord index (UCI). The umbilical cord coiling pattern commonly has a 0.2 coil/cm UCI.
But what happens when this length isn’t achieved, and the cord is considered straight?
What is the hypo-coiling of the umbilical cord?
When measuring the cord to see if its length is appropriately growing according to the growth of the fetus, the best time is to do it in the 22-28 weeks.
The cord measurement should be taken near the placenta or in the middle segment.
The distance between the coils should be measured from the inner edge of an arterial or venous wall to the outer edge of the next coil along one side of the umbilical cord.
When trying to measure the cord in the third trimester, the chances of the error increase. The volume of the amniotic fluid is reduced, resulting in errors in the measurement of the coiling of the cord.
A cord is hypo-coiling when there’s an abnormal decrease in the coiling. It’s defined as UCI less than the 5th percentile for the fetus’s gestational age.
Since the normal range lies somewhere as 0.20 +/- 0.1, when the intercoil distance increases, the lower the UCI value, and the more severe the hypo-coiling of the cord.
What are the causes of the coiling of the cord?
Hyaluronan is a compound believed to aid in the growth of the umbilical vessels and subsequent coiling.
But the role of genetic and acquired factors such as fetal movements in the standard coiling of the cord can’t be underestimated.
When it comes to a regular umbilical cord, it extends from the placenta to the fetal umbilicus, coiling as it traverses the distance between these two points.
Hypo-coiled cords are associated with increased fetal morbidity, including small GA fetuses, the risk for pre-term delivery, low birth weight neonates, and adverse perinatal outcomes.
The abnormal cord coiling is a chronic state and may have growth retardation, fetal intolerance to labor, and fetal demise effects on fetal well-being.
It’s been reported to be more frequent in females with gestational diabetes and preeclampsia.
How does a straight umbilical cord affect the baby?
The chances of a non-coiled or poorly coiled cord are approximately 4% to 5%.
The non-coiled cords are structurally less able to resist external forces.
Non-coiled cords are associated with intrauterine death, pre-term delivery, repetitive intrapartum heart rate decelerations, operative delivery owing to fetal distress, meconium staining, aneuploidy, and intrauterine growth restriction (IUGR).
How to treat a hypo-coiled cord?
There can be different types of abnormalities with the cord, including that of a hypo-coiled cord which may be potentially fatal or pose a severe threat to fetal health.
It’s of great clinical significance that early detection is done of these malformations to provide a proper diagnosis and plan of care.
FAQs
What determines the size of the umbilical cord?
The average length of the cord is 50-60 cm in a normal full-term newborn infant.
The size of the cord is an index of fetal activity and depends on the tension caused by the freely moving fetus, primarily during the second trimester.
How can I prevent a hyper-coiled umbilical cord?
Amnioinfusion and bed rest are best to reduce the compression of the vulnerable cord in cases of hyper-coiled cord, and it might improve the pathologic fetal-umbilical-placental circulation.
How common is a cord around a baby’s neck?
A cord around the baby’s neck is a complication that happens when it wraps itself one or more times around the neck.
It’s a nuchal cord and is common and occurs in about 15-35% of pregnancies.
Often, the cords around the neck don’t affect the pregnancy outcomes, but certain types of nuchal cords can pose a significant risk to the baby.
Can you see the umbilical cord on ultrasound?
The cord can be seen throughout most of the gestation and is detectable sonographically soon after visualization of the fetal pole.
The regular cord is 50-60 cm long and may coil as many as 40 times, usually to the left.
Can a short umbilical cord be seen on ultrasound?
An ultrasound examination can diagnose a short cord during the first trimester.
It’s crucial to take cord biometrics, including cord length, characteristics of the cord’s blood vessels, and the configuration of the cord on both ends.
To summarise
The umbilical cord is the physical and emotional attachment between the mother and the fetus. It provides nutrients to the baby while removing waste and works as an emotional link between both.
When the cord is found to be straight, the best option is to seek professional help from the doctors and adhere to the treatment suggested by them.
