Umbilical Cord Accidents as Cause of Stillbirth

Umbilical cord accidents account for approximately 10 percent of stillbirths.

umbilical cord
Most of the time, the likelihood of a cord accident is very low because the cord is well lubricated and resistant to compression -- but accidents can occur. A.D.A.M.

The concept of umbilical cord accidents can be frightening even for women with no history of stillbirth. "Cord accident" sounds so random and so unpredictable, and it's natural to want to know more about what causes cord accidents and whether it's possible to prevent them.

What a Cord Accident Is:

The term "cord accident" is a general term for something having disrupted the blood flow to the baby through the cord.

They account for 10 percent of stillbirths, according to Sthe tillbirth Collaborative Research Network. A cord accident might mean a true accident due to an entangled umbilical cord cutting off the baby's blood supply, or it might mean the cord failed because of medical factors. 

Causes of Cord Accidents

Cord accidents can be random or occur after medical risk factors. Random cord "accidents" would involve one of the following:

  • Knot in the cord or cord compression
  • Abnormal composition of the cord
  • Ruptured blood vessel in the cord
  • Prolapsed cord (umbilical cord begins to come through the cervix before the baby during labor)

But disruptions of the cord blood flow could also occur for other reasons, the most common causes of this would be:

Why Cord Accidents Are Rare

With all the kicking and acrobatics a baby does during pregnancy, you might wonder why cord accidents aren't more common.

The answer is that a normal umbilical cord is thickly coated in a substance called Wharton's jelly. This makes the cord very slippery and protects against the cord being compressed by the normal movements of the baby—and this is why having a medical condition that interferes with the normal functioning of the cord might theoretically increase the risk of a cord accident.

Preventing Cord Accidents

Some cord accidents are random in nature and probably cannot be prevented. Although sometimes if the problem is detected in time, physicians may be able to do something to boost the odds of the baby's survival, such as early delivery if the baby is in significant distress and past the age of viability. For this reason, it's important to notify your physician if you feel your baby is moving less or more than usual in late pregnancy.

It's interesting to note that one 2012 study in BMC Pregnancy Childbirth suggested that excessive movement or fetal hiccups (occurring daily and more than 4 times per day) warranted a fetal evaluation for an umbilical cord problem.

Of course, other cord accidents can occur after medical risk factors, such as having too little amniotic fluid, and physicians can sometimes pick up clues for these conditions during standard prenatal care, and then they can watch those pregnancies more closely. For this reason, attending prenatal appointments regularly will give your physician the opportunity to detect problems early and may decrease the risk of stillbirth.

A Word From Verywell

Although having a previous stillbirth is a risk factor for the subsequent pregnancy, researchers do not yet agree on the likelihood of a cord accident to happen again. One study by the Pregnancy Institute found that cord accidents could recur but there isn't much research on the matter.

Regardless, it makes sense to see a physician early along in a subsequent pregnancy after a stillbirth due to cord accident—the doctor may consider the new pregnancy to be high-risk and in need of additional monitoring.

Sources:

Collins JH. Umbilical cord accidents. BMC Pregnancy Childbirth. 2012; 12(Suppl 1): A7.

Pregnancy Institue: Pregnancy after Stillbirth and Home Fetal Heart Rate Monitoring via the Internet.

Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA2011 Dec 14;306(22):2459-68.

Continue Reading