The problem with the umbilical cord wrapping around the neck is that many mothers-to-be worry that it will affect their baby’s healthy growth. As we have written before, cord bypass and baby’s health cannot be directly equated. Here is what the obstetrician and gynecologist have to say about how to properly understand cord bypass and how not to talk about it: A common problem for mothers-to-be after ultrasound is cord bypass. This is because some obstetricians say that it is dangerous for the umbilical cord to be wrapped around the neck and that natural delivery may have serious consequences such as intrauterine hypoxia and asphyxia. Such a statement makes many mothers-to-be feel anxious. To ease your worries, let me tell you the real situation of cord winding. The English word for cord winding is Nuchal Cord, also known as Cord Around Neck (CAN). Some hospitals take an ambiguous approach to cord wrapping by not writing the Chinese language on the ultrasound report and only writing the abbreviation CAN for the doctor to see. If the cord is wrapped around the neck once, CAN1 is written, if it is wrapped around the neck twice, CAN2 is written, and so on. In fact, the umbilical cord wrapping around the neck is not as terrible as it is said to be. Here are the conclusions of the latest authoritative foreign literature. 1. It is very common for the umbilical cord to be wrapped around the neck once or several times, and it can be loose or tight. The incidence of cord wrapping is 15%-30% in all pregnant women. The umbilical cord can wrap around the fetal neck at any time, and it may either persist or come out at any time after it is wrapped. There is a large body of evidence suggesting that cord entrapment does not significantly increase poor fetal or neonatal prognosis, except for a few case reports suggesting that cord entrapment is associated with poor fetal or neonatal prognosis, but these reports are often retrospective and the number of cases is relatively small, so the evidence is not sufficient. 3. Screening for cord entrapment during pregnancy is generally not recommended, and even if cord entrapment is detected on ultrasound, it is not included in the ultrasound report. If a patient asks, they can be informed that cord winding is common and usually resolves on its own, and even if it persists, it does not significantly increase the risk of adverse pregnancy outcomes. For this reason, we no longer describe cord winding in the ultrasound report at our hospital because 1 in 3-5 pregnancies will be detected with cord winding, and it can occur or be removed at any time. We can’t monitor and follow up well on cord entanglement. Even if we don’t see it now, how can we guarantee that it won’t be there tomorrow? How can you say that the fetus won’t wind up tomorrow if you check for a cord winding today? Why go through the process of careful identification when cord entanglement does not significantly increase adverse fetal or neonatal outcomes? How can I explain to the mother-to-be if I find a cord bypass? A lack of explanation will not only increase the psychological burden of the mother-to-be, but also increase the cesarean delivery rate, so why bother? As mentioned above, prospective studies with large sample sizes have not found a significant increase in adverse neonatal outcomes associated with cord winding. But retrospectively, a few case reports have linked cord winding to poor fetal or neonatal prognosis. Why is this the case? According to 2005 statistics in the United States, the incidence of stillbirths is about 6 per 1,000. The causes of stillbirths are many and complex, and it is difficult to find the true cause if only a gross autopsy is performed. Since one out of every three to five fetuses will have a cord winding, it becomes a scapegoat when the real cause cannot be found, but in most cases the cord winding is wrongly accused. If cord winding is really a high risk as some people believe, why can’t prospective studies confirm it? The main reason for the association between cord winding and poor fetal or neonatal prognosis reported in small samples of cases should be concomitant, not causal, because the incidence of cord winding is so high that it can easily be taken to task in the event of stillbirth. In fact, the real relationship with poor prognosis of the fetus or newborn is true nodes of the umbilical cord, but the incidence of true nodes is very low and the detection rate by ultrasound is not high, so screening is not very meaningful. For mothers-to-be, instead of worrying about whether the umbilical cord is wrapped around the neck or not, it is better to count the fetal movements in late pregnancy as prescribed by the doctor to detect intrauterine distress in time.