Can Marginal Cord Insertion Correct Itself
When you were born, your umbilical cord was in one piece and connected to both of your parents’ bodies at one end. At the other end, it had two ends — one attached to your mother’s belly and one attached to what would become your stomach. As you grew, so did this section of the cord. That part between where it was attached to your mom and where it became your abdomen eventually split up. The larger portion of the cord became your umbilicus, or navel, while the smaller portion became your vena cava. This separation happened because as the fetus developed inside its mother, its growing pressure pushed on her uterine wall. Eventually, the fetal heart started pushing against the outer layer of the uterus causing that inner tissue to separate from the muscle layer. This is called “separation of the uteroplacental unit.” Once this happens, the baby continues developing outside the womb but still has access to oxygenated blood from its mother through the remaining umbilical artery and vein. These are known as the umbilical arteries and veins.
While most people don’t think much about their umbilical cords after birth, they’re actually pretty cool little pieces of history. For example, during the Middle Ages, when there was no anesthesia, doctors used an amputating tool made out of bone called a lancet to cut off any excess length of the umbilical cord. They also used sharp scissors to cut away the stump before stitching it back together, which caused bleeding and pain for the infant.
Most babies today have a standard amount of umbilical cord left behind once the cord is clamped. However, some infants may not develop properly due to issues like an infection in the cord or being delivered prematurely. If a baby is delivered early or if the labor goes long, then the medical staff may need to take action. When that happens, the umbilical cord can be either clamped or ligated. Clamping involves cutting off all of the blood supply to the remaining umbilical cord by tying off the connection with an elastic band. Ligating means severing the connection by using a small surgical knife to cut the cord just above the knot. Either way, the procedure usually takes less than 15 minutes and causes very little damage to the body.
There are three types of umbilical cord abnormalities: vascular, structural and fungal infections. Vascular problems include arterial or venous occlusion, which occurs when a large blood clot blocks an artery or vein. Structural problems occur when there is insufficient space between the layers of the umbilical cord. Fungal infections are the result of bacteria invading the umbilical cord.
If the cord becomes damaged during pregnancy or immediately following delivery, it’s known as marginal cord insertion. A velamentous cord insertion (VCI) is the most serious type of marginal cord insertion. Here’s how it works: Most placental mammals have four layers of tissue — amnionic membrane, chorionic plate, decidua and myometrium. During normal development, the amnionic membranes form a protective barrier around the fetus within the uterus. In a VCI, however, these membranes fail to seal the hole created by the baby’s head breaking through them. Instead, the amnionic membranes come into contact with the baby’s brain and spinal fluid. And since the amnion isn’t covered by a hard surface, the area is susceptible to infection.
In addition to creating a risk for meningitis, a VCI puts the baby at risk for hypoxia. Hypoxia is a condition in which the body doesn’t receive enough oxygen. Babies who suffer from VCI are often deprived of oxygen, which leads to brain injury and death. Luckily, VCIs are relatively rare. According to the National Center for Birth Defects and Developmental Disabilities (NCBDDD), only 5 percent of births involve a VCI.
Marginally inserted cords aren’t always completely severed. Sometimes, they’ll heal themselves over time. You might even notice that your navel looks slightly different. Let’s look at the process of healing a VCI on a human arm.
What Is Healing?
As we mentioned earlier, the umbilical cord splits into two main sections during development. One section connects to the placenta and serves the purpose of delivering nutrients to the baby and removing waste products. The second section attaches directly to the baby’s abdominal cavity. The latter functions like a pipe leading into a building.
During a VCI, the umbilical cord fails to separate fully. Instead, it stays in one continuous tube that runs down from the placenta to the baby’s abdomen. Like a pipe that hasn’t been capped, the unbroken section of cord is susceptible to infection. To prevent this, the umbilical cord develops a double-layered lining called Wharton’s jelly. Wharton’s jelly cushions the exposed portions of the umbilical cord and helps repair the wound created by the baby’s skull piercing through it.
After the initial insult, the cord undergoes several stages of healing. First, it forms granulation tissues. After the formation of new capillaries, scarring begins and collagen fibers begin to build up. Finally, as the fibrous connective tissues replace the original tissues, the cord becomes thicker. While the healing process varies based on the size and location of the tear, it typically takes six weeks to complete.
Can Marginal Cord Insertion Correct Itself?
Healing a VCI yourself seems impossible. But, thanks to modern medicine, it’s possible. Doctors use surgery to remove the extra skin and fat surrounding the affected area and suture it back together. This allows the newly formed scar tissue to strengthen. Surgery is also necessary if the cord needs to be removed entirely.
According to Dr. Michael S. Osterman, director of the Fetal Therapy Program at Massachusetts General Hospital, the chances of the umbilical cord self-correcting depend on how quickly the tear occurred. He said tears generally happen within hours of giving birth. Fortunately, he added, the majority of wounds heal without intervention. Still, if the cord is torn more than 24 hours postpartum, you should consult a doctor.
“A healthy person heals faster, but the key thing is that it does get better,” he said in an interview with WebMD. “It’s not going to grow back.”
Osterman says that although many people choose to leave their umbilicus intact, doing otherwise could cause complications later on. For instance, having your navel pierced for piercings or tattoos could lead to infection. Plus, the lack of an umbilicus can make wearing pants difficult.
Dr. Jennifer Breyer, assistant professor of obstetrics and gynecology at Columbia University Medical Center, told WebMD that although the umbilical cord heals naturally, it can’t do everything by itself. She recommended consulting a physician if you experience symptoms such as fever, redness, swelling, discoloration, discharge or foul odor.
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