Abnormal Torsion of Umbilical Cord

Abnormal Torsion of Umbilical Cord

Article
Women's Health
Diseases & Conditions
+1
Contributed byKashif M.Mohiuddin, MD, FRCPath+1 moreJun 29, 2020

What are the other Names for this Condition? (Also known as/Synonyms)

  • Abnormal Coiling of Umbilical Cord
  • Excessive Coiling of Umbilical Cord
  • Hypercoiling of Umbilical Cord

What is Abnormal Torsion of Umbilical Cord? (Definition/Background Information)

  • Normally, the umbilical cord has many twists and turns; the normal average being 0.2 twists per centimeter (cm) of the cord. Abnormal Torsion of Umbilical Cord is a condition affecting the umbilical cord, where there is excessive coiling of the umbilical cord
  • This can cause significant health issues in the developing fetus such as due to decreased blood supply to the fetus
  • The placenta is an organ that connects the developing fetus to the uterine wall. It is a disc shaped reddish brown structure that connects the fetus to the mother through the umbilical cord
  • The umbilical cord contains two umbilical arteries and one umbilical vein, providing a connection between maternal and fetal blood circulation
  • The normal function of placenta is to supply nutrients and oxygen to the fetus from the mother’s blood and remove wastes from the fetal body
  • Abnormal Torsion of Umbilical Cord is generally related to the presence of long umbilical cords, increased fetal movement, and cocaine use during pregnancy
  • Abnormal Torsion of Umbilical Cord requires close monitoring of the developing baby and appropriate treatment for an optimal outcome. The treatment and prognosis is dependent upon the severity of the complications and the pregnancy stage
  • Currently, there are no methods available to prevent Abnormal Torsion of Umbilical Cord during pregnancy

Who gets Abnormal Torsion of Umbilical Cord? (Age and Sex Distribution)

  • Abnormal Torsion of Umbilical Cord is a common condition; approximately 10% of the pregnancies can have hypercoiling of the cord. The condition can affect pregnant women of all ages
  • Women who are pregnant with both male and female fetuses can be affected, however there is a predilection for male fetuses
  • There is no racial, ethnic, or geographical predilection observed

What are the Risk Factors for Abnormal Torsion of Umbilical Cord? (Predisposing Factors)

The risk factors for Abnormal Torsion of Umbilical Cord may include:

  • Long length of the umbilical cord
  • Male fetus
  • Cocaine use by pregnant women
  • Polyhydramnios or increased fluid in the gestational sac

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Abnormal Torsion of Umbilical Cord? (Etiology)

Abnormal Torsion of Umbilical Cord is caused by hypercoiling (excessive coiling) of the umbilical cord due to factors such as:

  • Long cord
  • Increased fetal movement during pregnancy
  • Shortage of Wharton jelly (a gel-like material surrounding the umbilical vessels)

What are the Signs and Symptoms of Abnormal Torsion of Umbilical Cord?

The signs and symptoms of Abnormal Torsion of Umbilical Cord may include:

  • Decreased blood supply to the fetus
  • Compression of blood vessel resulting in fetal distress, such as abnormal fetal heart rate
  • Excessive hemorrhage/bleeding during childbirth, if thrombosis of the umbilical cord blood vessel takes place

How is Abnormal Torsion of Umbilical Cord Diagnosed?

The diagnosis of Abnormal Torsion of Umbilical Cord is made by a qualified healthcare professional during a prenatal ultrasound scan. The diagnosis may also involve the following:

  • Physical examination along with an evaluation of one’s medical history
  • A careful examination of the placenta by a pathologist after birth of the child, to macroscopically (gross visual exam) and microscopically analyze the placental tissue may help establish a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Abnormal Torsion of Umbilical Cord?

Complications due to Abnormal Torsion of Umbilical Cord may include:

  • Blood vessel compression within the cord leading to severe fetal distress
  • Reduced blood supply to the fetus can result in intrauterine growth retardation (IUGR) or even fetal mortality
  • Umbilical Cord Torsion has been associated with increased perinatal mortality
  • Thrombosis of umbilical cord may cause damage to multiple organs or even cerebral palsy in the newborn, due to decreased blood flow to the developing fetus

How is Abnormal Torsion of Umbilical Cord Treated?

  • A careful and periodic monitoring of the pregnancy is necessary since the presence of Abnormal Torsion of Umbilical Cord is considered to be a high-risk pregnancy
  • The condition can be a medical emergency in case of fetal distress. In such cases, an elective delivery of the baby should be considered taking into account the stage of pregnancy

How can Abnormal Torsion of Umbilical Cord be Prevented?

  • Currently, there are no definitive methods available to prevent Abnormal Torsion of Umbilical Cord
  • However, the avoidance of smoking and the consumption of alcohol and illicit drugs during pregnancy is strongly advised and recommended
  • A careful and periodic monitoring of the pregnancy is also advised and recommended

What is the Prognosis of Abnormal Torsion of Umbilical Cord? (Outcomes/Resolutions)

  • Abnormal Torsion of Umbilical Cord can be a life-threatening condition with a high mortality rate
  • A delayed treatment or a lack of treatment may result in the death of the baby, or cause adverse health complications for the baby

Additional and Relevant Useful Information for Abnormal Torsion of Umbilical Cord:

Please check back for periodic updates to our ‘physician approved content’.

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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Kashif M.Mohiuddin, MD, FRCPath picture
Reviewed by

Kashif M.Mohiuddin, MD, FRCPath

Pathology, Medical Editorial Board

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