Introduction
The umbilical cord, which is also known as the navel string, birth cord, or funiculus umbilicalis is a connection between the developing baby and the placenta. The major function of the umbilical vein is to supply oxygenated blood with nutrients to the baby from the placenta. Also, the umbilical cord helps carry the waste from the body of the baby along with low oxygen blood.
What Is The Importance Of Umbilical Cord?
As we know the functions of the umbilical cord, there are some abnormalities that can affect the umbilical cord and thus cause problems that can affect both the mother and the child.
-
Umbilical Cord Compression: This can result from the presence of a knot in the cord, entanglement of the cord, or a nuchal cord. The nuchal cord indicates the wrapping of the umbilical cord around the neck of the baby. It is not necessary that these conditions will always cause obstruction to the blood flow of the child.
-
Velamentous Cord Insertion: In this, the umbilical cord is positioned in the wrong place in relation to other blood vessels.
-
Single Umbilical Artery: The umbilical cord contains two arteries and one vein. In short, a single umbilical artery is when one artery in the umbilical cord is missing, which rarely happens in pregnancies. The vein transfers the oxygenated blood from the placenta to the fetus. The arteries carry the deoxygenated blood and waste matter from the fetus to the placenta. Hence, once in a while, primary agenesis or secondary atrophy of one of the arteries transpires, resulting in a single umbilical artery.
-
Umbilical Cord Prolapse: It is a rare type of complication but can prove to be fatal. In this, the umbilical cord can come out of the uterus with or even before the baby comes out.
-
Vasa Praevia: In this, the blood vessel surrounding the baby can rupture, leading to blood loss in the child.
What Is The Difference Between Early Versus Delayed Clamping?
A study done in 2013 showed that delayed cord clamping, which is one to three minutes after the birth of the baby, can be beneficial only if the management for jaundice, including phototherapy, is available for the baby. Also, delayed clamping can lead to an increase in the birth weight of the child, increased hemoglobin levels, and an increased risk of jaundice which might need phototherapy.
Features Of Normal Cord
-
Normal cords do not require any special treatment.
-
It is advisable to keep them dry, also known as natural drying, as the cords need to be dry before they can fall off.
-
There are certain changes in color when they get dry. They normally have a shiny yellowish hue or dominant color, which changes to brown or gray.
-
The cord is normally expected to fall off between one to three weeks.
Normal Navel or Belly Button
-
The navel starts to heal gradually after the cord has fallen off.
-
The center of the navel can look red where the separation of the cord had happened and is considered normal.
-
If the redness seems to be spreading onto the belly, it requires medical attention.
-
Also, it is not considered to be normal if there are some secretions from the navel.
-
Sometimes, a scab formation can be noticed on the navel. It is also normal. It heals and falls off on its own.
What Is Delayed Separation of Umbilical Cord?
Delayed separation of the umbilical cord indicates that the separation occurs after three weeks. The piece of the cord which remains on the baby is known as the umbilical stump, and the navel is also known as the belly button or umbilicus.
Why Is It Caused?
Although it is not necessary that an abnormality has to cause delayed separation of the cord, there may be certain disorders that should be ruled out. The delayed separation may be associated with an immune deficiency or immune disorder. The normal separation occurs through white blood cells (WBCs) infiltrating the area and leading to the death of cells in that area. This condition can occur if there is an inherited disorder of WBCs or other inflammatory cells. Some of the conditions include leukocyte adhesion deficiency (LAD), in which the WBCs cannot reach the umbilical cord. This LAD-type I is known to have high morbidity and mortality and, thus, requires early detection and management. The other condition is alloimmune neutropenia, in which the number of neutrophils (a type of WBCs) is decreased. The other reason could be the presence of infection, which may delay the natural process of separation.
How Can It Be Diagnosed And What Are The Complications?
If the cord does not separate in two to three weeks, it is advisable to consult a pediatrician to rule out any medical condition. The diagnosis includes molecular genetic testing for LAD, cell culture for infections, and various blood tests like blood count and blood function tests. There can be recurrent infections if the cord is there for a long time, and if not diagnosed and managed on time, it can be fatal, too, in some cases.
How Can It Be Managed?
It is necessary to keep the area dry and clean. The doctor may apply a dab of silver nitrate around four weeks of age on the umbilical cord and the surrounding area to fasten the drying.
Also, the following umbilical cord care in newborns by parents can prove to be useful,
-
Keep the stump clean. You can use gauze and water only to clean the area. Also, the sponge bathes the rest of the parts of the baby. Do not put the baby in a bathtub until the cord falls off.
-
Do not pull the cord even if it is hanging. Let it fall off naturally.
-
Keep an eye on the umbilical cord for any infection; if any infection occurs in that area, it can spread very quickly.
Following are the signs of local infection at the stump:
-
Drainage from the stump, which is foul-smelling and yellowish.
-
Redness.
-
Swelling.
-
Presence of any tenderness in the skin around the stump.
You should consult your physician if the baby has the following:
-
Poor feeding.
-
Fever ranging from 38 degrees Celsius or more.
-
Tiredness.
-
Poor muscle tone.
-
Bleeding.
Stop Alcohol: You should not rub the area with alcohol as it can kill the natural bacteria, which helps in the falling of the cord.
Diaper: Keep the diaper folded below the cord, as it will help keep the cord dry.
Conclusion
Delayed separation of the cord can be associated with some medical conditions and require immediate diagnosis and management. You can consult a specialist online through online medical platforms to know more about this condition.
