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nuchal cords...

Ob/Gyn   (1,955 Views 5 Comments)
by hoping to be an rn hoping to be an rn (Member) Member

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i know this really sounds stupid but how exactly do you reduce a nuchal cord? what if there are two or the one is very tight? where exactly do you clamp and cut? right at the baby's neck or at the cord coming out? i am sooo confused and am scared i will have a precip birth w/this occuring...

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AnnieOaklyRN is a BSN, RN, EMT-P and specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

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Well first you ask mom to stop pushing, then if the cord is loose enough that you can fit a couple fingers under it you slip it over the baby's head and continue delivery. If the cord is too tight to slip over then you must quickly put two clamps on and cut it between the clamps, just away from the neck on the end going to the placenta.

Sweetooth

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obnurse13 has 6 years experience and specializes in L&D, Postpartum, Newborn, Med-Surg.

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I agree with sweettooth, but keep in mind, once you cut that cord you have to deliver. God forbid you have should dystocia after the cut. Also, there is a move called the summersault where you move the fetal head to the side to help you be able to deliver through it. Research that.

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33-weeker has 20+ years experience.

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Yes. I agree. Even without a dystocia, those babies often need more rescusitation than babies with intact cords. Then again, if the baby is preciping, a dystocia is less likely than with moms who must push forever to move the kid along.

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OzMW has 21 years experience and specializes in Midwifery.

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I agree, caution is required. I rarely cut nuchal cords for that very reason. Most are manageable with the somersault thingy. I had one recently that was very tight and I had to cut it. First one I've done in as long as I can remember. There is heaps of research now to say cords shouldn't be cut until the pulsations stop due to anemia issues. So there needs to be a very good reason to clamp and cut.

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