Nuchal cord occurs when the umbilical cord becomes gets wrapped around the fetal neck by 360 degrees or more. Nuchal cords occur in about 10–30 % of fetuses and the incidence increases with increasing gestation age. Most are not associated with perinatal morbidity and mortality, however few studies have shown that nuchal cord can affect theoutcome of delivery with possible long-term effects on the infants.
Nuchal cords are more likely to cause problems when the cord is tightly wrapped around the neck, with effects of a tight nuchal cord conceptually similar to strangulation. Umbilical cord compression due to tight nuchal cords may cause obstruction of blood flow in thin walled umbilical vein, while infant’s blood continues to be pumped out of the baby through the thicker walled umbilical arteries causing hypovolemia, acidosis and anemia. Some of these infants have physical features secondary to tight nuchal cords that are distinct from those seen with birth asphyxia.
The muscle strain patterns resulting from difficult labor or other interventions , due to cord around neck can affect suckling in the new born baby, thus resulting in challenges like difficulty in latching, extra hard suckling causing nipple injuries etc. Such babies need appropriate interventions from an experienced Lactation Consultant and occupational therapist.