Nuchal cord: everything you need to know

Published by admin on December 10, 2025December 10, 2025

Cord entanglement, also known as nuchal cord, is a condition in which the umbilical cord becomes wrapped around the baby’s neck. This can happen during pregnancy or at the time of delivery.

Although it is a relatively common condition, identified in about 1 in 3 pregnancies, it is important to understand its risks and implications.

What is cord entanglement?

Cord entanglement can manifest in two ways:

• Body cord: In this case, the umbilical cord wraps around any part of the fetal body.
• Nuchal cord: Here, the umbilical cord is wrapped around the fetus’s neck, completing 360 degrees.

The umbilical cord can wrap around the baby’s body in up to 38% of pregnancies. A nuchal cord—a cord wrapped around the neck—is reported at delivery in 5-37% of pregnancies. In addition, cord loops with more than two turns around the fetal neck occur in 4% of pregnancies. The main risk factors for this condition are:

• Reduced amniotic fluid volume (oligohydramnios).
• Increased fetal activity (when the fetus moves more during pregnancy).
• Advanced gestational age (the chances of diagnosing cord entanglement increase as the pregnancy progresses).

Cord entanglement tends to resolve spontaneously as the pregnancy progresses or during labor. However, in some cases, it may persist.

Diagnosis of cord entanglement

Unless there is evidence of fetal problems, routine testing for the sole purpose of prenatal diagnosis of cord entanglement is not recommended. However, this condition may be diagnosed incidentally on third-trimester ultrasound, representing a benign finding in most cases. So, you don’t need to worry. Diagnosis of the condition may be necessary when there are signs of fetal distress, especially when there is evidence of changes in the baby’s heart rate. In this situation, your doctor will likely order a color Doppler ultrasound or 3D ultrasound to view the sagittal and transverse sections of the fetal neck.

Conduct

There is no major concern regarding cord entanglement around the baby’s body. In other hand, if it is a nuchal cord, there is greater concern, as the umbilical cord can compress the arteries that carry oxygen to the baby’s brain. However, compression occurs only in very rare cases.

The most appropriate route of delivery in the case of cord entanglement (or nuchal cord) is an important issue for the health of the mother and baby. Let’s explore the considerations and options:

• Vaginal Delivery (Normal): Vaginal delivery is the most common choice and usually does not require a cesarean section in cases of cord entanglement. The type of delivery is determined primarily by the vitality of the fetus. The benefits of vaginal delivery include being a natural and generally faster process, as well as a quicker postpartum recovery. However, it is important to closely monitor the baby’s well-being during labor.
• Cesarean Section: A cesarean section is indicated in rare cases when there is significant and persistent fetal growth restriction associated with cord entanglement or if there is cord compression due to the descent or rotation of the fetal head. A cesarean section offers precise control over the timing of birth and may be necessary for specific situations. However, recovery after a cesarean section can take longer, and there are surgical risks associated with this procedure.

In summary, the decision about the route of delivery will depend on the individual assessment of each case. The doctor will consider the mother’s health, the baby’s vitality, and other relevant factors to make the best decision. Remember to discuss your concerns and options with your healthcare provider to make an informed decision.