Newborn Umbilical Cord

In this article you will get the information about the structure, function, cutting, clamping, caring, uses, advantages and disadvantages of newborn umbilical cord. If you want a detailed information about the newborn umbilical cord read full article.

What Is Baby Umbilical Cord? Definition Of Newborn Umbilical Cord?

newborn umbilical cord
Baby Umbilical Cord

Umbilical cord, the life supporting system of a baby. Umbilical cord plays an important role in the birth a new born baby, in taking care of all the needs of baby which are necessary for the baby in the mother’s womb. It connects your baby to placenta.

It contains three vessels, two arteries and one vein whose function is transport of the blood. The arteries are used to transport blood from the baby to the placenta and the vein transports the blood back to the baby.

Blood transported by the arteries contains waste products, like carbon dioxide (CO2) , from the baby’s metabolism. Carbon dioxide is transferred across the placenta to the mother’s bloodstream and then to her lungs, where it’s breathed out. And the oxygenated blood, by red blood cells, in the mother’s circulation, is transported across the placenta to the baby umbilical vein. In addition to the oxygen, the umbilical vein also transports nutrients from the placenta to the baby.

The umbilical cord is also called navel string, birth cord or funiculus umbilicalis which forms a conduit between the developing embryo or fetus and he placenta. Vessel present in the umbilical cord have a protective coating called WHARTON’S Jelly, and the cord is coiled like a spring so that the babe can move around freely in the womb.

Baby Umbilical Cord
newborn umbilical cord

The pattern of coiling is established by nine weeks itself and is usually in a counterclockwise direction. However, the cord can coil later, and sometimes isn’t established until twenty weeks. The movement of the baby seems to encourage the coiling if the cord.

Usually the cord is attached to the center of the placenta, although sometime’s attached near the edge. Very occasionally, before entering the placenta finally, it divides into its separate vessels. The diameter of the cord is usually under one to two cm and it is 23cm long, which is twice the length needed to ensure that there are no problems at the time of delivery of the baby.

The vessels of the cord close by themselves after the delivery. At first the arteries close, helped by their thicker muscular walls. This prevents blood loss from the mother’s body to the placenta. The umbilical vein closes later ( slightly at fifteen seconds, but only completed by three or four minutes ).

This can ensure that the blood continue to return to the baby during the first few minutes of life. As a result, many feel that a slight delay before clamping the cord can be beneficial to the new born baby. In this cord, there are no nerves present therefore cutting the cord after the delivery of the baby is a painless and a very soft procedure.

Structure Of Newborn Umbilical Cord

The Newborn Umbilical Cord is a helical and tubular blood conduit connecting the fetus to the placenta. By the 12th week of gestation the umbilical cord achieves its final form. The structure of the umbilical cord receives only a cursory glance during many obstetric ultrasound examinations: with imaging limited to documenting the number of vessels within the cord and the insertion sites at the fetus and placenta.

newborn umbilical cord

The umbilical cord develops from and contains remnants of the yolk sac and allantois. It forms by the fifth week of development by replacing the yolk sac as the source of nutrients for the embryo. It is not connected the mother’s circulatory system directly, but instead joins the placenta, which helps in the transport of materials and from the maternal blood without allowing direct mixing.

Approximately the length of this cord is equal to the crown-rump length of the fetus throughout the pregnancy period. The umbilical cord in a full term neonate is usually about fifty centimeters in length and about two centimeters in diameter. Within the placenta the diameter of the umbilical cord decreases rapidly.

The fully patent umbilical artery has two main layers: an outer layer consisting of circularly arranged smooth muscle cells and an inner layer which shows rather irregularly and loosely arranged cells embedded in abundant ground substance staining metachromatic. The smooth muscle cells of the layer are rather poorly differentiated, contain only a few tiny myofilaments and are thereby unlikely to contribute actively to the process of post-natal closure.

It’s lining is a good source of messenchymal and epithelial stem cells. Their advantages include a better harvesting, and multiplication, and immunosuppressive properties that define their potential for use in transplantations. Their use would also overcome the ethical objections raised by the use of embryonic stem cells.

The umbilical cord contains wharton’s jelly which is a gelatinous substance made from mucopolysachharides which protects the blood vessels inside. It contains one vein, which carries oxygenated, nutrient-rich blood to the fetus, and two arteries that carry deoxygenated, nutrient-depleted blood away. Occasionally, only two vessels (one vein and one artery) are present in the umbilical cord. This is sometimes related to fetal abnormalities, but it may also occur without accompanying problems.

It is unusual for a vein to carry oxygenated blood and for arteries to carry deoxygenated blood (the only other examples being the pulmonary veins and arteries, connecting the lungs to the heart). However, this naming convention reflects the fact that the umbilical vein carries blood towards the fetus’s heart, while the umbilical arteries carry blood away from the baby.

The blood flow through the umbilical cord is approximately 35 ml / min at 20 weeks, and 240 ml / min at 40 weeks of gestation.  Adapted to the weight of the fetus, this corresponds to 115 ml / min / kg at 20 weeks and 64 ml / min / kg at 40 weeks.

Function Of Baby Umbilical Cord

The umbilical cord is considered to be the both physical and emotional attachment between the mother and fetus. This structure allows for the transfer of oxygen and nutrients from the maternal circulation into fetal circulation while simultaneously removing waste products from fetal circulation to be eliminated maternally. So we can say it has three main functions:-
1. It supplies oxygen
2. It delivers the nutrients
3. It helps to withdraw blood rich in co2 and depleted in nutrients.

Blood from this cord can also be used to treat a variety of diseases like bone marrow etc.

It has three separate functions. Primarily, it serves as a blood source for the neonate. As we all know that the fetus is unable to breathe hence it is especially important. And thus allows the fetus to obtain the oxygen it needs to live. Because the fetus has no way of intaking the food, the umbilical cord also serves as a source of nutrients, including calories, proteins, fats, as well as vitamins and nutrients.

Finally, the cord also serves to transfer waste products and deoxygenated blood away from the fetus to the maternal circulation, where it can be processed and excreted.

As we have discussed that instead of normal consecutive tissue and skin it is made up of Wharton’s jelly. Inside the cord is one vein, which contains oxygenated blood, and two arteries. The vein goes all the way to the fetus’s liver, where it splits into two.

One part of the vein supplies blood to the hepatic poral vein, which in turn supplies blood to the liver. The other branch, which is known as the ductus venosus, supplies 80% of the blood to the human body, allowing oxygen and other vital nutrients to circulate throughout the fetus.

In the absence of external interventions, the umbilical cord occludes physiologically shortly after birth, explained both by a swelling and collapse of wharton’s jelly in response to a reduction in temperature and by vasoconstriction of the blood vessels by smooth muscle contraction.

newborn umbilical cord

In effect, a natural clamp is created, halting the flow of blood. In air at 18 °C, this physiological clamping will take three minutes or less. In water birth, where the water temperature is close to body temperature, normal pulsation can be 5 minutes and longer.

Closure of the umbilical artery by vasoconstriction consists of multiple constrictions which increase in number and degree with time. There are segments of dilatations with trapped uncoagulated blood between the constrictions before complete occlusion. Both the partial constrictions and the ultimate closure are mainly produced by muscle cells of the outer circular layer. 

In contrast, the inner layer seems to serve mainly as a plastic tissue which can easily be shifted in an axial direction and then folded into the narrowing lumen to complete the closure. The vasoconstrictive occlusion appears to be mainly mediated by serotonin and thromboxane A2. 

The artery in cords of preterm infants contracts more to angiotensin II and arachidonic acid and is more sensitive to oxytocin than in term ones. In contrast to the contribution of Wharton’s jelly, cooling causes only temporary vasoconstriction.

Within the child, the umbilical vein and ductus venosus close up, and degenerate into fibrous remnants known as the round ligament of liver and the ligamentum venosum respectively. Part of each umbilical artery closes up (degenerating into what are known as the medical umbilical ligaments), while the remaining sections are retained as part of the circulatory system.

Newborn Umbilical Cord Care

newborn umbilical cord care

After the birth the baby umbilical cord is clamped immediately. The clamp is removed before the baby goes home from the hospital. The umbilical cord stump should fall off in 7 to 14 days. A little amount of blood or wetness is normal when it falls off. At home, one should:

1. Keep the cord dry and clean. The drier the cord, the sooner it will fall off.

2. To clean around the base of the cord use a cotton swab dipped in the alcohol 3 to 4 times a day or when soiled with urine or stool. You may continue to apply alcohol even after the stump falls off until the area is dry.

3. Until the baby umbilical cord falls off and the area looks healed do not give the baby a tub bath. This will take 7 to 10 days. Give him or her a sponge bath instead which will be very helpful for the new born baby.

4. To ensure that the diaper does not hit the cord when the baby kicks, roll the diaper as low as you can.

Call your baby’s health care provider if you notice:

1. A bad smell coming from the cord.

2. Redness around the cord

3. A yellow or greenish discharge.

4. Bleeding.

5. A cord the remains soft and moist.

Why your baby has an umbilical cord stump?

During pregnancy, the umbilical cord supplies nutrients and oxygen to your developing baby. After the birth, the cord is no longer needed-so it’s clamped and snipped. This leaves behind a short stump.

Signs of a problem:-

During the process of healing, it’s normal to see a little blood near the stump. Much like a scrab, the cord might bleed a little when it falls off.

newborn umbilical cord problems

However, if the area of umbilical cord oozes pus, the surrounding skin becomes red and swollen, or the area develops a pink moist bump, contact the doctor of the baby. These could be the signs of an cord infection. Prompt treatment is needed to stop the infection from spreading.

Also, talks the the baby’s doctor id the stump has not separated after 3 weeks. This can be a sign of an underlying problem, such as infection or immune system disorder.

ADVANTAGES OF THE BABY UMBILICAL CORD

The blood of this cord can save lives. Cord blood is very rich in the stem cells that can morph into all sorts of blood cells, which can be used to treat diseases that can harm blood and the immune system, such as leukemia and certain cancers, sickle cell anemia and some metabolic disorders.

The stem cells are essentially the building blocks of human body. The earliest stem cells in the human body are those found in the human embryo. The stem cells will eventually give rise to the every cell, tissue and organ in the fetus body.

newborn baby umbilical cord
newborn umbilical cord

Unlike a regular cell, which can only replicate to create more of its own kind of cell, a stem is pluripotent. When it divides, it can make any one of the 220 different cells I the human body. Stem cells also have the capability to self-renew, they can reproduce themselves many times over.

The CORD BLOOD BANK helps in treating a number of diseases that requires stem cells transplants also called bone marrow transplant, such as certain kinds of leukemia or lymphoma, aplastic anemia, severe sickle cell disease, and severe combined immunodeficiency.

Cord-blood banking basically means collecting and storing the blood from within the baby umbilical cord after the baby is born. This cord blood contains blood forming stem cells.

Cord blood contains 10 times the amount of stem cells found in bone marrow of an equal proportion. The stem cells found in the blood of the cord have a greater ability to regenerate because they are younger then the stem stem cells found in the bone marrow.

AVAILABILITY OF CORD BLOOD

Some 30000 individuals are diagnosed annually with disease that require stem cell transplants. However. Of these individuals, 75% do not have the matching relative for the transplant and 70% cannot find a matching donor.

newborn umbilical cord
newborn umbilical cord

Because severe types of cancer as well as certain immune deficiencies and blood disorders such as specific cases of anemia require prompt treatment, many individuals die before they are able to find a bone marrow transplant donor.

DISADVANTAGE OF NEWBORN UMBILICAL CORD

The baby umbilical cord sometimes consist of cancer-causing toxicant. In multiple American and international studies, cancer causing chemicals have been found in the blood of umbilical cords. These originate from plastics, computer circuit board, fumes and synthetic fragrance among others.

newborn umbilical cord

Over 300 chemical toxicants have been found, including bisphenol A (BPA), tetrabromobisphenol A(TBBPA), teflon related perfluorooctanoic acid, galaxolide and synthetic musks among others. The American studies showed higher levels in African Americans, Hispanic Americans ans Asian Americans due, it is thought, to living in area of higher pollution which makes the cord toxic.

CLAMPING AND CUTTING OF THE CORD

Clamping of the cord can be done at different time; however, delaying the clamping of the baby umbilical cord until at least one minute after the birth improves outcomes as long as there is the ability to treat the small risk of jaundice if it occurs. It is followed by the cutting of the cord, which is painless and very smooth due to the absence of nerves.

newborn baby umbilical cord Cutting
newborn umbilical cord cutting

The cord is extremely tough and so a sharp instrument is required to cut it. While umbilical serverance may be delayed until after the cord stopped pulsing(5-20 minutes after the birth), ordinarily there is no loss of either venous or arterial blood while cutting the baby umbilical cord.

Current evidences neither supports, nor refuses, delayed cutting of the cord, according to the American Congress of Obstetricians and Gynecologists (ACOG) guidelines.

There are cord clamps which incorporate a knife. These clamps are safer and faster, allowing one to first apply the cord clamp and then cut the cord. After the cord is clamped and cut the newborn wears a plastic clip on the navel area until the compressed region of the cord has dried and sealed sufficiently.

The length if the umbilical left attached to the newborn varies by practise; in most hospital settings the length of cord left attached after clamping and cutting is minimal. In the united states, however, where the birth occur outside of the hospital and an emergency medical technician(EMT) clamps and cuts the cord, a longer segment up to 18 cm (7 in) in length is left attached to the new born.The remaining umbilical stub remains for up to 10 days as it dries and then falls off.

WHAT HAPPENS TO THE CORD AFTER THE BIRTH OF THE BABY?

The umbilical cord from the mother is expelled within half-hour after the birth of the baby. It is still attached to the placenta, which is commonly called “the afterbirth”. it is no longer needed with its function completed , and is discarded by the mother’s body. Yes, a new cord develops for each baby.

UMBILICAL CORD PROLAPSE

It is a complication that occurs prior to or during delivery of the baby. In a prolapse, the cord drops through the open cervix into vagina ahead of the baby. The cord can then become trapped against the baby’s body during the delivery.it occurs in about 1 in 500 pregnancies.

The risk of death of the baby is about 10%. however much of this risk is due to congenital anomalies or pre-maturity. The most common serious morbidities associated with cord prolapse related to asphyxia: hypoxic brain injury and cerebral palsy. There are few long term studies looking at long term sequelae of cord prolapse.

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