Umbilical cord

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Umbilical cord
A newborn at 45 seconds. Preparation to cut the baby's umbilical cord by affixing the second of two clamps. Mucus is sucked from the face while the mother holds the baby's right lower leg.
Latin funiculus umbilicalis, chorda umbilicalis
Precursor Allantois

In placental mammals, the umbilical cord is a tube that connects a developing embryo or fetus to its placenta. It normally contains three vessels, two arteries and one vein, buried within Wharton's jelly, for the exchange of nutrient- and oxygen-rich blood between the embryo and placenta. The presence of only two vessels in the cord is sometimes related to abnormalities in the fetus, but may occur without accompanying abnormalities.

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[edit] Explanation

The umbilical cord develops from, and contains, remnants of the yolk sac and allantois. In humans, the umbilical cord in a full term neonate is usually about 50 cm long and about 2 cm in diameter.

A newborn with cord stump still visible after 7 days.
A newborn with cord stump still visible after 7 days.

In the third stage of labour, after the child is born, the uterus spontaneously expels the neonate's placenta along with the cord from the mother's body, 10-45 minutes after the birth. However, the umbilical cord is generally clamped during or within minutes of birth and severed shortly after, a practice of "active management of labor" which has become increasingly controversial due to the lower transfer of placental blood to the neonate and associated stressors. The health benefits of non-clamping of the cord and delayed umbilical severance as well as nonseverance are receiving attention in medical journals.

After the cord is clamped and cut (Western obstetrical protocol) the newborn wears a plastic clip on the navel area, where the remaining umbilical stub remains for up to 2-3 weeks until it falls off. In nonseverance scenarios, also called Lotus Birth, the umbilical cord is wrapped up to within an inch of the newborn's belly, and dries and naturally separates.

[edit] Makeup and composition

The umbilical cord is made of Wharton's jelly, not ordinary skin and connective tissue. There are no nerves, so cutting it is not painful. There is ordinarily no significant loss of either infant or maternal blood while cutting the cord. In many Western cultures the umbilical cord is traditionally cut by the father of the baby. The cord contains two arteries which carry deoxygenated blood (from the fetus back to the mother) and one vein that carries oxygenated blood (from the mother to the fetus). Today there are umbilical cord clamps which combine the cord clamps with the knife. These clamps are safer and faster, allowing one to first insert the cord clamp and then cut the umbilical cord.

[edit] Cord blood

Recently, it has been discovered that the blood within the umbilical cord, known as cord blood, is a rich and readily available source of primitive, undifferentiated stem cells (i.e. CD34+ and CD38-). These cord blood cells can be used for bone marrow transplant.

A newborn with umbilical cord still attached (3 minutes.)
A newborn with umbilical cord still attached (3 minutes.)

Some parents have opted to have non-clamping of the umbilical cord and extended-delayed cord cutting or nonseverance Lotus Birth in order to provide for full neonatal transfer of this valuable cord blood during the most critical time for neonatal health as well as longterm health benefits.

Others have chosen to have this blood diverted from the baby's umbilical blood transfer through early cord clamping and cutting, to freeze for long-term (and costly) storage at a cord blood bank should the child ever require the cord blood stem cells (for example, to replace bone marrow destroyed when treating leukemia). This practice is somewhat controversial,[citation needed] with critics asserting that early cord blood withdrawal actually increases the likelihood of childhood disease. The Royal College of Obstetricians and Gynaecologists 2006 opinion states, "There is still insufficient evidence to recommend directed commercial cord blood collection and stem-cell storage in low-risk families."

In the future, cord blood-derived embryonic-like stem cells (CBEs) may also be banked and matched with other patients, much like blood and transplanted tissues. The use of CBEs would eliminate the ethical difficulties associated with embryonic stem cells (ESCs).[1]

[edit] Problems

A number of abnormalities can affect the umbilical cord, which can cause problems that affect both mother and child:

  • Single umbilical artery
  • Umbilical cord prolapse
  • Vasa previa
  • Nuchal cord
  • Umbilical cord knot
  • Umbilical cord entanglement

[edit] Lotus birth

Lotus Birth is a practice of leaving the cord uncut after birth so that the baby is left attached to its placenta until the cord naturally separates. This usually takes 1–3 days.

Umbilical cord clamp
Umbilical cord clamp

[edit] Animals

In other mammals, the mother animal generally will bite the cord off separating the placenta from the baby. It is usually consumed by the mother which nourishes her, recycles the protein, and reduces tissue that would attract scavengers or predators. In chimpanzees, the mother focuses no attention on umbilical severance, instead staying still and nursing and holding her baby (with cord, placenta et al) until the cord dries and separates within a day of birth, at which time she leaves the cord and placenta on the forest floor where it is recycled by scavengers. This was first documented by zoologists in the wild in 1974.[citation needed]

[edit] Other uses for the term "umbilical cord"

The term "umbilical cord" or just "umbilical" has also come to be used for other cords with similar functions, such as the hose connecting a surface-supplied diver to his surface supply of air and/or heating, or a space-suited astronaut to his spacecraft.

The phrase "cutting the umbilical cord" is used symbolically to describe a child's breaking away from the parental home.

[edit] Additional images