" umbilical cord
True Knots
In the real knots - unlike the false ones, given by the physiological vascular loops - there is an actual knotting of the umbilical cord, with consequent strangulation - more or less severe - of the blood vessels that run through it.
Numerical Anomalies of the Umbilical Vessels
Numeric anomalies of the umbilical vessels can also be found at birth; the most frequent one concerns the absence of one of the two umbilical arteries which, albeit rarely, can be associated with fetal alterations and chromosomal diseases.
Proincidence and Prolapse
Two other possible complications concern procidence and umbilical cord prolapse; they occur (see figure) when one or more loops of the funiculus present themselves in front of the part presented with intact (procidence) or broken (prolapse) membranes. In the latter case, in practice, the cord is expelled first and during delivery the baby compresses it on the vaginal wall blocking the flow of blood and oxygen.
After giving birth
With the cut of the umbilical cord, the newborn loses physiological contact with its mother, only to rediscover it in her womb during breastfeeding.
Immediately after birth, the funiculus is cut about 10 cm away from the baby's abdomen, closing the residual stump with an elastic or a plastic clip and wrapping it in a dry sterile gauze. This maneuver favors the occlusion of the vessels. , avoiding bleeding and infections. The umbilical cord does not contain sensitive nerve fibers, so the baby does not feel any pain when cutting.
The cut segment still attached to the child's abdomen goes slowly against drying. After the excision of the funiculus the umbilical vessels are thrombosed rapidly and the stump, no longer supplied by the vessels, dries, taking on a blackish-brown color. appendix will be kept dry and clean, and covered with a sterile gauze to be changed several times a day, until, around the 5th -10th day of life, it will come off by itself.
The health care staff will give the nurse the necessary indications on the hygiene of the umbilical stump, suggesting - for example - to wash your hands carefully before touching it, avoid covering it with the edge of the diaper, keep it well dry and ventilated during the day and avoid to detach it prematurely waiting for its spontaneous fall.
Infections of what is left of the umbilical cord are quite rare and can be heralded by symptoms such as purulent (pus) and foul-smelling discharge, redness and conspicuous swelling.
Umbilical cord and stem cells
Umbilical cord blood is rich in hematopoietic stem cells, with potential use for transplantation purposes to treat rather serious blood diseases (currently therapeutic applications are actually very limited). For this reason, the umbilical cord and the placenta are no longer considered waste to be incinerated, but a precious resource to be kept for donations or for autologous use. On the basis of these considerations, in recent years real umbilical cord banks have arisen, in which the blood extracted from the placenta and from the funiculus at the moment of birth is kept; a business, this, particularly flourishing and that for the moment is running much faster than the concrete scientific advances on adult stem cells.
