On Nuchal Cord and An Update

Non-Stress Test. Captures fetal heart rate and contraction rate.

During my 32nd-going-33rd week appointment with my OB-Gyne, it was found out on ultrasound that there's an umbilical cord loop/coil near my baby's neck, or what is referred to as a nuchal cord. I was reassured by my doctor that all throughout her practice (and she's a really prominent practitioner here in Manila), she has seen nuchal cords in about 70% of her patients and that it is, by itself, not deadly. 

However, because it is a condition that may pose risks to the baby, I was advised to immediately undergo what they call a Non-Stress Test (NST) and a Doppler Test. Apart from that, I was advised to be very very vigilant in monitoring my baby's movement. Our protocol was that whenever I don't feel any movement in an hour, I will stuff myself with food and lie on my left and wait for 30 minutes until I feel my baby move. If there's still no movement, I should go see her immediately. I was told that it is always better to be over-vigilant and safe about it than be sorry.

Since then, I've been closely monitoring my baby's movement even while at work. Just a day after I hit my 33 weeks, I noticed that my baby wasn't moving from 5am until I reached work around 6am. I grabbed a sandwich and waited for 30 minutes. There's no movement. I was thinking that maybe my baby was just sleeping. I continued working and noticed that around 9am, my baby's still not kicking. I ate a heavy breakfast and in fact even took a very sweet drink and dessert. 30 minutes came by and my baby's still not moving. Around 11am, I'm already very worried and scared. I know that our protocol calls only for an hour of no or decreased fetal movement and that in my case, I already allowed 6 hours to pass by!

I was picked up by hubby from work and my OB-Gyne advised me to have an ultrasound and a repeat Non-Stress Test. While the NST is being conducted, I was holding a gadget which I had to press any time I feel a fetal movement. And in the 40 minutes that I was undergoing the test, I recorded 19 movements. I felt relieved that the baby's heart rate is fine, that he's moving, and that my contraction rate is very low.

My doctor was advised of the results of the NST but to be very sure about it, I was advised to be on a 24-hour monitoring in the hospital. Even if we're not prepared for it, we can't decline because it's all for the baby. We feel safer being there, with straps all around my belly, just to make sure that the baby's fine.

I had routine urinalysis and complete blood count tests as soon as I was admitted. I was scheduled for a Doppler Test the following day. Everything was fine until the following morning when the baseline of my baby's heart rate became lower then 120. At first, we're seeing 115-119, then it became 108-110, and then went as low as 104-105. Not alarmingly low but it's not a good sign. I was put on oxygen and was given steroid shots for baby's lung development so that in case he gets delivered earlier than 37 weeks, we're assured that his lungs are mature enough. That time, it's around 5 in the morning to 6:30am. Same time when I didn't feel my baby move just before I got confined.

I was given breakfast and was told to eat a heavy one. Soon enough, my baby's heart rate picked up and went back to 130-140. And that's the reading until we got discharged in the afternoon. We're so relieved! Whew!

As of this post, my baby's fine and really very active. However, during my previous check-up, I was told that on ultrasound, it looks like my baby has a double coil :( Anyways, I'm due for another appointment tomorrow and moving forward, it's gonna be a weekly appointment for us. We're preparing for a C-section sometime February 22 onwards and that's just basically 3 weeks from now!

Before I end this post, I would like to share this article with you.

Even though nuchal cords are common and occur 25% – 35% of the time, rarely a baby’s cord will be wrapped so tightly around their body that the cord is compressed and oxygen delivery to the baby is compromised.  When this occurs, a cesarean is prudent and in its absence, a stillbirth could occur.  Fortunately, stillbirth from cord accidents, which include nuchal cords and nuchal knots, are rare and occur in 1.5 per 1,000 (0.15%) deliveries.  If your baby does have a nuchal cord, the risk of infant death is less than 0.4% – 0.6%. Thus, even though nuchal cords occur in about one third of births, they rarely result in the death of a baby. However, this is no consolation to those who have experienced the horror of their child’s death because when you are the statistic, it doesn’t matter how rarely something occurs.

To wrap this post up, I just want to tell all preggy ladies out there whose babies also have nuchal cords to not be afraid. Just keep on praying and be very observant of your baby's movement. Let's all do our best and if need be, make certain sacrifices if only to really monitor fetal movement. I was advised to stop working because I can monitor baby's movements properly when lying down and not when sitting in front of the computer busy doing something. Again, keep on praying and have faith that God will not want anything harmful to our babies. 

Take care everyone!