What should be done if the umbilical cord is wrapped once around the fetal neck at 32 weeks of gestation?

At 32 weeks of gestation—i.e., the third trimester—pregnant women often experience increasing anxiety. During this stage, the fetus has relatively unrestricted movement within the uterine cavity, making nuchal cord (umbilical cord around the fetal neck) relatively common. If ultrasound reveals a nuchal cord, there is no need for excessive concern—as long as it does not form a true knot, it generally poses no risk. In most cases, the fetus can spontaneously reposition itself and resolve the cord entanglement through natural movement.

However, if the umbilical cord is tightly wrapped around the neck, it may compromise fetal oxygenation and lead to asphyxia or hypoxia. If the nuchal cord persists without resolution prior to labor onset, cesarean delivery is typically recommended to minimize risks. Once normal fetal positioning is restored, vaginal delivery may be considered.

Throughout pregnancy, close attention should be paid to fetal movements. Color Doppler ultrasound should be used to assess umbilical artery blood flow, and routine fetal heart rate monitoring—including scoring—should be performed. Pregnant women are encouraged to learn how to use a fetal heart rate monitor for basic home-based surveillance and to plot standardized monitoring curves. Additionally, sleeping in the left lateral decubitus position helps optimize umbilical blood flow and supports healthy fetal development. Regular, moderate physical activity, consumption of fresh vegetables and fruits, maintenance of perineal hygiene, and adherence to scheduled prenatal visits are all essential components of healthy pregnancy management.