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UMBILICAL CORD OBG SYN.4

📚🩺 Umbilical Cord

📘 Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams

✅ I. Introduction / Definition

  • The umbilical cord is a vital lifeline connecting the developing fetus to the placenta.
  • It facilitates the exchange of nutrients, oxygen, and waste products between the fetus and the mother.

✅ “The umbilical cord is a flexible, tubular structure that connects the fetus to the placenta, providing essential support for fetal growth and survival.”

📖 II. Structure of Umbilical Cord

  • Average Length: 50–60 cm.
  • Diameter: 1.5–2 cm.
  • Composed of:
    • 2 Umbilical Arteries: Carry deoxygenated blood from fetus to placenta.
    • 1 Umbilical Vein: Carries oxygenated blood from placenta to fetus.
  • Wharton’s Jelly:
    • A gelatinous substance that protects and cushions the blood vessels.
  • Covered by:
    • Amniotic membrane.

📖 III. Functions of Umbilical Cord

  • Transports oxygen and nutrients to the fetus.
  • Removes carbon dioxide and waste products from the fetal circulation.
  • Provides a flexible, protective connection between the fetus and placenta.
  • Assists in maintaining fetal temperature balance.

📖 IV. Nursing Responsibilities

  • Assess the cord immediately after birth for the presence of two arteries and one vein.
  • Ensure proper cord clamping and cutting using sterile techniques.
  • Monitor for signs of cord prolapse during labor.
  • Educate mothers about proper cord stump care to prevent infections like omphalitis.
  • Report any cord abnormalities to the pediatrician.

📚 Golden One-Liners for Quick Revision:

  • Normal umbilical cord contains 2 arteries and 1 vein.
  • Wharton’s Jelly protects the vessels from compression.
  • Cord prolapse is an obstetric emergency requiring immediate action.
  • The cord is typically clamped 1–3 minutes after birth to allow for placental transfusion.
  • Average length of the umbilical cord is 50–60 cm.

✅ Top 5 MCQs for Practice

  1. What is the normal composition of the umbilical cord?
    🅰️ 1 artery, 1 vein
    ✅ 🅱️ 2 arteries, 1 vein
    🅲️ 2 arteries, 2 veins
    🅳️ 1 artery, 2 veins
  2. What is the function of Wharton’s Jelly?
    🅰️ Provides nutrition
    🅱️ Produces hormones
    ✅ 🅲️ Protects umbilical vessels
    🅳️ Facilitates waste excretion
  3. Which of the following is a true abnormality of the umbilical cord?
    🅰️ False knot
    ✅ 🅱️ True knot
    🅲️ Wharton’s jelly swelling
    🅳️ Amniotic band
  4. When is the ideal time to clamp the umbilical cord?
    🅰️ Immediately after birth
    🅱️ After 10 minutes
    ✅ 🅲️ 1–3 minutes after birth
    🅳️ Before the first cry
  5. Which condition is associated with a single umbilical artery?
    🅰️ Normal finding
    ✅ 🅱️ Congenital anomalies
    🅲️ Cord prolapse
    🅳️ Polyhydramnios

📚🩺 Abnormalities of Umbilical Cord

📘 Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams

✅ I. Introduction / Definition

  • Abnormalities of the umbilical cord refer to structural or functional deviations from the normal anatomy of the umbilical cord.
  • These abnormalities can pose significant risks to fetal well-being and the outcome of labor.

✅ “Umbilical cord abnormalities are conditions affecting the structure, length, number of vessels, or positioning of the cord, which may lead to fetal complications during pregnancy and delivery.”

📖 II. Types of Umbilical Cord Abnormalities

🟢 1. Length Abnormalities

  • Short Umbilical Cord (<30 cm)
    • Associated with:
      • Delayed descent of fetus.
      • Uterine rupture due to traction during labor.
      • Abruptio placentae.
    • Management: Requires careful handling during delivery.
  • Long Umbilical Cord (>70 cm)
    • Associated with:
      • Cord entanglement around neck (nuchal cord).
      • Cord prolapse.
      • True knots formation.
    • Management: Continuous fetal monitoring during labor.

🟢 2. Vascular Abnormalities

  • Single Umbilical Artery (SUA)
    • Normally, the cord contains 2 arteries and 1 vein.
    • SUA is associated with:
      • Congenital anomalies (renal, cardiac, CNS defects).
      • Intrauterine Growth Restriction (IUGR).
    • Management: Requires detailed anomaly scans and fetal monitoring.
  • Persistent Right Umbilical Vein
    • Rare condition, may indicate congenital heart or chromosomal abnormalities.

🟢 3. Structural Abnormalities

  • True Knot
    • Actual knot in the cord, can tighten and reduce fetal blood supply.
    • May cause fetal distress or stillbirth.
  • False Knot
    • Localized swelling or looping of vessels within Wharton’s jelly.
    • Clinically insignificant.
  • Cord Cyst
    • Fluid-filled cysts within the cord, may be associated with chromosomal anomalies.

🟢 4. Positional Abnormalities

  • Cord Prolapse
    • The umbilical cord descends into the birth canal ahead of the fetal presenting part.
    • Leads to fetal hypoxia; an obstetric emergency.
  • Nuchal Cord
    • Cord encircles the fetal neck one or more times.
    • May cause variable decelerations in fetal heart rate.

📖 III. Nursing Responsibilities

  • Immediate assessment of the cord after birth to confirm number of vessels.
  • Monitor for signs of fetal distress during labor, especially in cases with known cord abnormalities.
  • Prepare for emergency interventions like cesarean section in case of cord prolapse or fetal compromise.
  • Educate mothers about the importance of regular antenatal check-ups and anomaly scans.
  • Provide postnatal care and observation for babies with known cord abnormalities.

📚 Golden One-Liners for Quick Revision:

  • Normal umbilical cord contains 2 arteries and 1 vein.
  • Cord prolapse is an obstetric emergency requiring immediate intervention.
  • Single umbilical artery is associated with congenital anomalies.
  • True knot can compromise fetal blood flow; false knot is harmless.
  • Nuchal cord may lead to fetal heart rate decelerations during labor.

✅ Top 5 MCQs for Practice

  1. What is the most common complication associated with a single umbilical artery?
    🅰️ Normal fetal development
    ✅ 🅱️ Congenital anomalies
    🅲️ Polyhydramnios
    🅳️ Preeclampsia
  2. Which of the following umbilical cord abnormalities is considered harmless?
    🅰️ True knot
    ✅ 🅱️ False knot
    🅲️ Cord prolapse
    🅳️ Nuchal cord
  3. What is the normal length of the umbilical cord?
    🅰️ 20–30 cm
    🅱️ 30–50 cm
    ✅ 🅲️ 50–60 cm
    🅳️ 70–90 cm
  4. Which abnormality of the umbilical cord is an obstetric emergency?
    🅰️ Nuchal cord
    🅱️ Single umbilical artery
    ✅ 🅲️ Cord prolapse
    🅳️ False knot
  5. How many vessels are normally found in a healthy umbilical cord?
    🅰️ 1 artery, 1 vein
    🅱️ 2 arteries, 2 veins
    ✅ 🅲️ 2 arteries, 1 vein
    🅳️ 1 artery, 2 veins
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Categorized as OBG-PHC-SYNOPSIS, Uncategorised