The umbilical cord plays a vital role in fetal development, carrying oxygen and essential nutrients to the baby. In some cases, it may wrap around the baby’s neck — a situation known as a nuchal cord. This phenomenon is common, occurring in approximately 15–35% of pregnancies. While it usually does not cause harm, certain circumstances may increase the risk of complications.

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Risk Factors for a Nuchal Cord

Some conditions increase the likelihood of a nuchal cord:

• Multiple pregnancy (twins, triplets)
• Excess amniotic fluid
• Intense fetal movements
• A longer umbilical cord
• Reduced Wharton’s jelly (the protective substance inside the cord)

Types and Potential Complications

There are two main types:

• Type A (“unlocked”) – can spontaneously unwind without danger.
• Type B (“locked”) – forms a knot that cannot loosen on its own, potentially causing issues during birth.

Usually, a nuchal cord does not interfere with blood or oxygen flow. However, when tightly wrapped or looped multiple times, possible complications include:

• Hypoxic-ischemic encephalopathy
• Fetal heart rhythm abnormalities
• Intrauterine growth restriction
• Meconium in the amniotic fluid, which might lead to respiratory complications

A nuchal cord can be accurately identified using color Doppler ultrasound (up to 97% accuracy).

Management and Delivery

Detecting a nuchal cord is not an automatic indication for cesarean delivery. Instead, physicians typically recommend:

• Close ultrasound monitoring
• Regular fetal heart rate evaluations
• Continuous intrapartum monitoring during labor

If fetal distress occurs, medical teams may perform manual maneuvers to release the cord or proceed with an emergency cesarean section.

Most babies with a nuchal cord are born healthy, provided that appropriate monitoring is ensured.

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Umbilical Cord Wrapped Around the Neck

If you have questions related to umbilical cord wrapped around the neck or would like recommendations on evaluating and monitoring your newborn during the first days of life, you may request an individual consultation at any time. A thorough assessment helps determine the most suitable monitoring and support plan for your child.

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