Umbilical Cord Knots In Pregnancy - What Should You Know?

During pregnancy, the umbilical cord is said to be the lifeline of the unborn foetus as it supplies the baby everything it needs to grow, like oxygen and food. It is also the thing that connects a baby to its mother. The umbilical cord is a white twisted cord that looks like a telephone cord. It contains two arteries and a vein. While the vein carries blood rich in oxygen and nutrients to your baby, the arteries carry the deoxygenated blood and other waste products back. Also, the umbilical cord is protected by a sticky substance called the Wharton's jelly. This layer of protection also is the one that prevents the tangling of the cord.

Typically, the umbilical cord of the baby is 2 feet long until the time of birth. Due to the cramped space in the womb weeks before the birth of the baby, combined with the baby's continuous movements, the umbilical cord sometimes gets knotted in the womb. Most mothers fret when their umbilical cord gets knotted as this directly affects the oxygen supply to the baby. While this may be true, umbilical knots do not always pose serious risks to the baby.

Umbilical cords are indeed a common occurrence during pregnancy. Find out everything you need to know about umbilical cord knots below.

What Are Umbilical Cord Knots?

The umbilical cord gets knotted due to the movement of the baby inside the womb. This usually happens early on during the pregnancy and is mostly harmless. The umbilical cord knots itself when the baby passes through a loop.

The chances of the umbilical cord getting knotted are more when the amniotic fluid in the womb is present in excess and if the baby is quite active inside. Also, if the umbilical cord is abnormally long, it may result in knots.

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Umbilical knots usually do not tighten due to the presence of the sticky substance that surrounds these cords. But at times when it happens, it poses a risk to the baby as it may cut off their oxygen supply and lower their heart rate.

True Knots And False Knots

Not all knots are dangerous. Some knots just look like knots but aren't. Basically, the knots on the umbilical cord can be divided into two types - true knots and the false knots.

While true knots are caused due to the looping of the cord due to the baby's activity inside the womb, false knots are just some extra blood vessels looping on each other inside the Wharton's jelly.

True knots when tightened can restrict the baby's blood supply. But false knots pose no serious harm to the baby and are quite common. They are also called pseudo knots.

How Common Are True Knots During Pregnancy?

Umbilical cord knots are extremely common during pregnancy, occurring in about one in every 100 pregnancies. Knots are usually caused early on during the pregnancy and often untangle on their own. However, in cases where the knot tightens, the baby's blood supply and be restricted and chances of a miscarriage are high.

The statistics for fatalities due to umbilical cord knots are about 1 in every 2000 pregnancies.

What Causes Umbilical Cord Knots?

Though umbilical cord knots are relatively a common occurrence during a pregnancy, the chances increase due to the following reasons-

1) If the umbilical cord is abnormally large, there are high chances of the cord being knotted inside the womb.
2) Increased activity of the foetus can further lead to it looping around the cord resulting in an umbilical knot.
3) This phenomenon is known to be extremely common if there is more of amniotic fluid present inside the womb.
4) Also, if the size of the foetus is small, the umbilical cord may get entangled due to its activity.

What Are The Symptoms Of Umbilical Cord Being Knotted?

The major symptom of an umbilical cord knot is decreased foetal movement, which is the direct result of decreased heart rate and low oxygen supply. The lesser the heart rate, the tighter is the knot and the more problematic it may be for the unborn baby.

Umbilical cord knots are usually detected by an ultrasound scan or a Doppler but often times, they are not visible in the scan as well. It can only be diagnosed if the mother experiences a sharp fall in the foetal movement all of a sudden.

What Are The Risks Involved For The Mother And The Baby?

Umbilical cords pose no direct risks to the mother but the baby may suffer from oxygen deprivation if the knot tightens.

Usually, the knots in the umbilical cord do not tighten due to the presence of a sticky protective layer called Wharton's jelly. However, if the knots do tighten over time, this may increase the chances of foetal death and brain damage. This may lead to a miscarriage, typically in the third trimester of the pregnancy.

At such times, an emergency Caesarean can be performed to increase the chances of the baby's survival.

How Can Umbilical Knots Be Handled?

If there is decreased foetal activity noticed by the mother and true knots are diagnosed, the heart rate and the movements of the foetus are closely monitored. However, if the condition of the foetus worsens, an emergency C-section can be the only way out.

If the knot is noticed during delivery, it is safe to perform a C-section under such cases as well due to the fact that the knot can tighten when the baby moves through the vaginal canal. This may increase the risk of brain damage due to asphyxiation.

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It is said that women with previous pregnancies having umbilical knots are at a higher risk of the condition repeating in their subsequent pregnancies as well. Therefore, if you come under this criterion, it is important to have regular scans and foetal heart rate checks to diagnose a knot.

Umbilical cord knots are not known to have any long-term effects on the baby once they are born healthy.