Cord entanglement- wrapping the umbilical cord of the fetal parts (neck, limbs, torso). It occurs quite often (15-25%).
In most cases, there is a single O. n. Around the neck of the fetus, less often - two-fold, rarely - three-fold. Sometimes O. n. Around the neck of the fetus is combined with the entanglement around the torso, arms or legs. The bowl takes place with a long umbilical cord, but it also happens with a shortened cord. O. of the item promote transverse and pelvic presentations of a fruit, its big mobility. Owing to O. of the item. Its relative shortening comes that can cause the clinical manifestations characteristic of a short umbilical cord.
In most cases O. of the item is not tight, and fetal and placental circulation is not broken. O. of the item, especially in the 2nd period of childbirth, can cause intrauterine asphyxia. At the same time, the fetal heartbeat slows down during the attempt, and after its termination the heart rate is slowly and stepwise restored. The shorter the umbilical cord becomes when entwined, the earlier and more intensively signs of intrauterine asphyxia become apparent.Nek-roy diagnostic value at O. of the item have umbilical cord noise. Not being an indication for intervention, they also require monitoring of the fetal heartbeat.
A negative effect on the fetus O. p. Has only when it is tight. In these cases, it can lead to the birth of a dead fetus. An important role in the prevention of stillbirths belongs to the control of the fetal heart activity. Timely installed O. of the item can serve as the indication to Cesarean section, extraction of a fruit by forceps obstetricians, and sometimes - only to a perineotomy (a section of a crotch). When receiving childbirth in cases of O. n. Around the neck after the birth of the head should be removed from her umbilical cord loop; in case of repeated and tight entanglement, when the loop cannot be removed, it is necessary to quickly put clamps on it and cross.