What should be done if the fetal umbilical cord is wrapped around the neck twice?

Fetal nuchal cord (umbilical cord wrapped around the neck twice) should be managed through enhanced fetal movement monitoring, regular prenatal check-ups and assessments, maintaining proper body positions, avoiding strenuous activities, and medical interventions when necessary. Immediate medical attention is required if abnormal fetal movements occur or prenatal evaluations indicate fetal distress in utero.

1. Enhanced fetal movement monitoring: Count fetal movements at fixed times each day. Normal fetal activity is 3–5 movements per hour, with no fewer than 10 movements within 12 hours. Sudden increases or decreases in fetal movement may indicate fetal hypoxia and require prompt attention.

2. Regular prenatal assessment: Use ultrasound to monitor umbilical blood flow, fetal development, and fetal position, and perform fetal heart rate monitoring to evaluate fetal well-being in utero, enabling timely detection of abnormalities.

3. Maintain proper body position: In the second and third trimesters, adopt a left lateral recumbent position to increase uteroplacental blood flow and reduce the risk of umbilical cord compression. Avoid prolonged supine positioning.

4. Avoid strenuous exercise: Minimize vigorous activities such as quick turns, running, or jumping. Avoid sudden changes in posture that could pull on the umbilical cord and worsen the nuchal cord condition.

5. Medical intervention when necessary: If the nuchal cord persists near term or signs of fetal distress appear, the doctor will decide whether to proceed with cesarean delivery or intensify intrapartum monitoring based on the clinical situation.

Pregnant women should ensure adequate sleep, maintain a balanced diet rich in nutrients, stay emotionally stable, avoid excessive anxiety, and engage in moderate, gentle physical activities such as walking to support healthy fetal development and a smoother delivery.