Umbilical cord blood

Circular of the umbilical cord are single or multiple winding cord around the fetus segments (neck, trunk, limbs), most frequently around the neck. Coil around torso are called scarf or camisole.
 ClassificationCircular can be tight or loose, single or multiple (cases cited in the literature are up to seven coils around the neck).
 EtiopatologenieLong cord and amniotic fluid promotes excess cord wrapping around the fetus, during its active movements, in a period ranging from weeks to months before the birth. This translates into shorter accidental mechanism, cord compression or compression of the fetal soft tissues involved.
 The consequences of this anomaly is manifested in different ways:- By compression of the umbilical vessels appears that fetal distress during labor progressively worse, culminating in the expulsion when circular tightens. BCF rate changes cause fetal distress, which can be reached in cases of severe bradycardia;- By jugular compression when the neck is circular, is embarrassed by the return flow in the brain, which accentuates cerebral hypoxia and stasis, creating favorable prerequisites installation meningo-cerebral bleeding;- Influence on labor materialized in difficulty to accommodate the fetal skull and sometimes its deflection. In breech, circular or may cause secondary deflexiunea primitive fetal skull, leading to the birth of the head locking mechanism.
 DiagnosisClinical signs suggesting the diagnosis of cord blood around her neck are:- Funicular this breath, which you can listen to the fetal neck in labor;- BCF alteration rate during contractions, which cause fetal head descent- This phenomenon during the expulsion of the fetal head descent during contractions, followed by his ascension between contractions, the same as that which occurs when the short cord.
 Fetal prognosis is reserved by fetal distress occurs in 50% of cases. Intrapartum fetal death, although unlikely, is a rare event.
 ConductIn natural birth are required as follows:- Assistance in the first period right on time to detect fetal distress installation;- Rapid completion of delivery in the event of acute fetal distress (through the application of forceps or axtragere)- After clearing the channel soft skull and finding this circular, this presentation is issued by passing over or close by when sectioning between two clamps.
 In fetal distress induced by the circular cord tight, if necessary conditions are indeplimite practicing surgery, a Caesarean delivery is indicated.