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Omphalitis of newborn
Specialty	Neonatology

Omphalitis of newborn is the medical term for inflammation of the umbilical cord stump in the neonatal newborn period, most commonly attributed to a bacterial infection. Typically immediately after an infant is born, the umbilical cord is cut with a small remnant (often referred to as the stump) left behind.

Normally the stump separates from the skin within 3–45 days after birth. A small amount of pus-like material is commonly seen at the base of the stump and can be controlled by keeping the stump open to air to dry. Certain bacteria can grow and infect the stump during this process and as a result significant redness and swelling may develop, and in some cases the infection can then spread through the umbilical vessels to the rest of the body.

While currently an uncommon anatomical location for infection in the newborn in the United States, it has caused significant morbidity and mortality both historically and in areas where health care is less readily available. In general, when this type of infection is suspected or diagnosed, antibiotic treatment is given, and in cases of serious complications surgical management may be appropriate.

What is an inflammation of the umbilical cord called?

Introduction – Omphalitis is an infection of the umbilicus and/or surrounding tissues, occurring primarily in the neonatal period. It is limited to around the umbilicus in the majority of newborns. However, it can rapidly progress to systemic infection and death, with an estimated mortality rate between 7% to 15%.

What causes umbilical cord inflammation?

The umbilical cord is a tough, flexible cord that carries nutrients and blood from birth mom to baby during pregnancy. After birth, the cord, which has no nerve endings, is clamped (to stop bleeding) and cut close to the navel, leaving a stub. The stub generally falls off in one to three weeks after birth.

During birth and the clamping and cutting process, germs can invade the cord and cause infection. Infection of the umbilical cord stump is called omphalitis. Omphalitis is rare in the United States, United Kingdom, and other countries where people have easy access to hospitals. Read on to learn how to identify and treat an umbilical cord infection.

It’s normal for the clamped cord to develop a scab at its end. It may even bleed a little bit, especially around the base of the stump when it’s ready to fall off. But the bleeding should be light and quickly stop when you apply gentle pressure. While slight bleeding is normal and usually nothing to be concerned about, signs of infection may include:

red, swollen, warm, or tender skin around the cordpus (a yellow-greenish liquid) oozing from the skin around the corda bad smell coming from the cord fever a fussy, uncomfortable, or very sleepy baby

The umbilical cord has direct access to the bloodstream, so even a mild infection can become serious quickly. When an infection enters the bloodstream and spreads (called sepsis), it can cause life-threatening damage to the body’s organs and tissues.

1. Contact your child’s pediatrician immediately if you notice any of the above signs of an umbilical cord infection.
2. Umbilical cord infection is fatal in up to about 15 percent of babies with an umbilical cord infection, so it’s considered a medical emergency.
3. Premature babies are at increased risk for severe complications from this type of infection because they already have a weakened immune system.

To determine the most appropriate treatment for your child’s infection, a medical professional will usually take a swab of the infected area. This swab can then be examined in the lab so that the exact germ that’s causing the infection can be identified.

1. When doctors know which germ is responsible, they can better pinpoint the right antibiotic to fight it.
2. Once the cause of the symptoms is identified, treatment largely depends on the extent of the infection.
3. For minor infections, your child’s doctor may recommend applying an antibiotic ointment a few times a day on the skin surrounding the cord.

An example of a minor infection is if there’s a small amount of pus, but your child otherwise seems fine. Minor infections can become more serious when left untreated, however, so it’s important to see a doctor whenever an umbilical cord infection is suspected.

• For more serious infections, your baby will likely need to be hospitalized and given intravenous antibiotics to fight the infection.
• Intravenous antibiotics are delivered through a needle inserted into a vein.
• Your child may be in the hospital for several days while they are receiving the antibiotics.

Babies given intravenous antibiotics typically receive them for about 10 days. They may then be given additional antibiotics via their mouths. In some cases, the infection may need to be surgically drained. If the infection has caused tissue to die, your child may also need an operation to remove those dead cells.

When the serious infection is caught early, most babies recover fully within a couple of weeks. But they usually need to stay in the hospital while they receive intravenous antibiotics. If your baby had surgery to drain the infection, the opening may have been “packed” with gauze. The gauze will keep the cut open and allow the pus to drain.

Once the draining stops, the gauze is removed and the wound will heal from the bottom up. Just a few years ago, hospitals routinely covered a baby’s cord stump with an antiseptic (a chemical that kills germs) after it was clamped and cut. Nowadays, though, most hospitals and pediatricians advise “dry care” for cords.

• Dry care involves keeping the cord dry and exposing it to air to help keep it free from infection.
• According to research published in the journal Medicine, dry cord care (compared to using an antiseptic) is a safe, easy, and effective way to help prevent cord infection in healthy babies born in hospitals in developed areas.

Dry cord care tips:

Clean your hands before you touch the baby’s cord area. Avoid getting the stump wet as much as possible. Use sponge baths to cleanse your baby until the stump falls off, and avoid sponging the area around the stump. If the stump does get wet, gently pat it dry with a clean, soft towel.Keep your baby’s diaper folded under the stump until it falls off instead of laying the diaper band across the stump. This will allow air to circulate and help dry the stump.Gently sponge away any pee or poop that collects around the stump with some water-moistened gauze. Let the area air dry.

While not care tips per se, other strategies may also help reduce risk for umbilical cord infection, such as having skin-to-skin contact or breastfeeding your baby. By placing your bare-chested baby against your own bare chest, known as skin-to-skin contact, you can expose your baby to normal skin bacteria.

1. According to a 2006 study of Nepalese newborns published in American Journal of Epidemiology, babies who got skin-to-skin contact were 36 percent less likely to develop an umbilical cord infection than babies who didn’t have this kind of skin exposure.
2. Breastfeeding allows you to pass antibodies (substances that can help fight disease) to your baby, which can help their immune systems develop and strengthen.

In the United States, United Kingdom, and many other countries, umbilical cord infections are rare in healthy, full-term babies born in hospitals. But cord infections can happen, and when they do, they can become life-threatening if not caught and treated early.

What causes problems with umbilical cord?

What is the umbilical cord? The umbilical cord is a tube that connects you to your baby during pregnancy. It has three blood vessels: one vein that carries food and oxygen from the placenta to your baby and two arteries that carry waste from your baby back to the placenta.

• A substance called Wharton’s jelly cushions and protects these blood vessels.
• The umbilical cord starts to form at about 4 weeks of pregnancy and usually grows to be about 22 inches long.
• Umbilical cord conditions include the cord being too long or too short, not connecting well to the placenta or getting knotted or squeezed.

These conditions can cause problems during pregnancy, labor and birth, If you have one of these conditions, your health care provider may find it during pregnancy on an ultrasound, An ultrasound is a prenatal test that uses sound waves and a computer screen to show a picture of your baby inside the womb.

• Your baby is premature, This means he’s born before 37 weeks of pregnancy. Babies born this early may have more health problems at birth and later in life than babies born on time.
• Your baby is low birthweight, This means he weighs less than 5 pounds, 8 ounces at birth.
• Your baby is in a breech position. This means he’s not head-down for labor and birth.
• The umbilical cord is too long.
• Your provider ruptures your membranes to start or speed up labor. Membranes are the tissue that connect the amniotic sac to the uterus (womb).
• You have too much amniotic fluid, This condition is called polyhdramnios,
• You’re having twins or more,

For most babies, umbilical cord prolapse doesn’t cause problems. But if your baby’s not getting oxygen because the cord is pinched, it can cause stillbirth unless your baby’s born right away. Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy.

1. If your water breaks and you feel something in your vagina, go to the hospital right away.
2. Your provider can look for cord prolapse by checking your baby’s heart rate and doing a pelvic exam on you.
3. He may be able to take pressure off the umbilical cord by moving the baby.
4. If the cord is pinched, you may need to have a cesarean section (also called c-section) instead of a vaginal birth,

A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. A vaginal birth is the way most babies are born – it’s when your uterus contracts to push your baby out through the vagina. What is a single umbilical artery? Single umbilical artery is when one artery in the umbilical cord is missing.

It happens in about 1 in 100 singleton pregnancies (1 percent) and about 5 in 100 multiple pregnancies (5 percent). A singleton pregnancy is when you’re pregnant with just one baby. A multiple pregnancy means you’re pregnant with more than one baby (twins, triplets or more). We don’t know what causes single umbilical artery.

About 2 in 10 babies (20 percent) with a single umbilical artery have health problems, including heart, kidney or digestion problems and genetic conditions, Digestion is the process of how your body breaks down food after you eat. A genetic condition is caused by a gene that’s changed from its regular form.

• A detailed ultrasound of your baby
• Amniocentesis, In this test, your provider takes some amniotic fluid from around your baby in the uterus (womb). The test checks for birth defects and genetic conditions in your baby. You can get this test at 15 to 20 weeks of pregnancy. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops or in how the body works.
• Echocardiogram. This is a special ultrasound that check’s your baby’s heart.

What is vasa previa? Vasa previa is when one or more blood vessels from the umbilical cord or placenta cross the cervix. The cervix is the opening to the uterus (womb) that sits at the top of the vagina. These blood vessels aren’t protected by the umbilical cord or the placenta, so they can tear during labor.

This can cause life-threatening bleeding in your baby. Torn blood vessels cause death in at least half of babies with vasa previa. Even if the blood vessels don’t tear, pressure on them during labor can cause problems for your baby. Your provider may find vasa previa on an ultrasound or during a pelvic exam during your pregnancy.

When this happens, you may need to have a c-section to help make sure your baby’s born safely. Vasa previa is rare; it happens in just 1 in 2,000 to 3,000 births (much less than 1 percent of births). We don’t know what causes it, but you may be at risk for it if you:

• Have a velamentous insertion of the umbilical cord. This is when the umbilical cord doesn’t connect correctly to the placenta.
• Have placenta problems like placenta previa, This is when the placenta is very low in the uterus and covers all or part the cervix.
• Are pregnant with more than one baby

What is a nuchal cord? A nuchal cord is an umbilical cord that gets wrapped around a baby’s neck. Babies with a nuchal cord usually are born healthy, but it sometimes can affect their heart rate. Your provider can see a nuchal cord on an ultrasound and usually can slip the cord off the baby’s neck during labor and birth.

What are umbilical cord knots? Knots in umbilical cords can form early in pregnancy when your baby moves around in the womb. Knots happen most often when the umbilical cord is too long and in pregnancies with identical twins. Identical twins share one amniotic sac, which makes it easy for the babies’ umbilical cords to get tangled.

Umbilical Cord Stem Cells: Regeneration, Repair, Inflammation and Autoimmunity – Neil Riordan PhD P1

The amniotic sac (also called bag of waters) is inside the uterus (womb) and is filled with amniotic fluid. About 1 in 100 pregnancies (about 1 percent) have a knot in the umbilical cord. If a knot gets pulled tight, it can cut off your baby’s oxygen. This can cause miscarriage or stillbirth.

Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Your provider looks for umbilical cord knots on your ultrasound. If you have a knot, you may need to have a c-section to help keep your baby safe. What is an umbilical cord cyst? Umbilical cord cysts are sacs of fluid in the umbilical cord.

They’re not common—less than 1 in 100 pregnancies (less than 1 percent) has an umbilical cord cyst. Your provider may find an umbilical cord cyst during an ultrasound. She’s more likely to find them in the first trimester than in the second or third trimesters.

1. True cysts contain fluid from the original embryo that developed into your baby. These cysts usually go away on their own and are located close to where the umbilical cord connects to the baby.
2. Pseudocysts (also called false cysts) are more common than true cysts. They’re found anywhere along the umbilical cord. The fluid in the cysts comes from Wharton’s jelly. These cysts may be linked to genetic conditions in your baby.

If your provider finds a cord cyst during an ultrasound, she may recommend additional tests, like amniocentesis, a detailed ultrasound and genetic tests to check for birth defects. If your cysts are large, you may need to have a c-section to keep the cysts from breaking, which can cause problems for your baby during labor and birth. Last reviewed: June, 2016

Which disease affects the umbilical cord?

This complication, called umbilical cord prolapse, is a rare medical emergency. It can deprive your baby of oxygen and cause permanent brain damage. Immediate delivery is necessary.

When should I worry about the umbilical cord?

Signs of a problem – During the healing process, it’s typical to see a little blood near the stump. Much like a scab, the cord stump might bleed a little when it falls off. However, contact your baby’s health care provider if the umbilical area oozes pus, the surrounding skin becomes red and swollen, or the area develops a pink moist bump.

How do you know if umbilical cord is infected?

Signs of an Infected Umbilical Cord Stump – It’s unlikely your baby’s umbilical cord stump will become infected, but if you notice any of these signs of an infected umbilical cord, contact your baby’s healthcare provider. These are some of the signs of an infected umbilical cord:

A smelly yellow discharge from the stump area A reddening of the skin around the stump Swelling of the navel area Your baby crying when you touch the stump, indicating it is tender or sore.

It’s normal to see crusted discharge, dried blood, or a little bleeding when the umbilical cord stump falls off. Bleeding is not necessarily a sign that your newborn’s belly button is infected, but if your baby’s umbilical cord area continues to bleed ask your child’s healthcare provider for advice.

Can a umbilical hernia go away naturally?

How Do You Treat and Repair an Umbilical Hernia? Disease and Condition: Umbilical hernias will not go away naturally and need medical treatment to repair them. The only way to repair an umbilical hernia is through surgery. Hernias develop when an internal part of the body pushes through a weak point of muscle or tissue. Most types of hernias develop in or adults.

Umbilical hernias are more common in infants, and 20% of are born with one. An occurs near the (umbilicus) when an intestinal loop pushes through the abdominal wall. They can look like an outie belly button. It’s estimated that about 10% of all abdominal hernias are umbilical hernias. The main sign of an umbilical is the appearance of a sac or pouch either in or around the belly button.

In babies or infants, they usually don’t cause any, Adults may not feel any, but some do feel discomfort. Typically, umbilical hernias can get bigger when you:

LaughCryUse the toilet

The umbilical hernia usually shrinks again when you lie down or relax. The sac usually contains fat, intestine, or fluid inside. Many babies who are born with umbilical hernias heal naturally within their first year of life. The hernia goes back in and the muscles seal, solving the problem with no medical intervention.

In fact, 90% of children who are born with an umbilical hernia naturally heal by the time they are five years old. Adults can also get these kinds of hernias. In adults, umbilical hernias can cause noticeable discomfort. The most common causes for umbilical hernias in adults include: Unlike umbilical hernias in babies, these hernias will probably grow bigger and become more uncomfortable as time goes on.

They will not go away naturally and need medical treatment to repair them. If left untreated, umbilical hernias can get stuck, which causes them to be even more painful. When umbilical hernias are stuck, or “incarcerated”, they can cause,, and can even prevent you from being able to pass,

1. A strangulated umbilical hernia occurs when part of the intestine is in the hernia pouch and loses blood supply.
2. This can cause vomiting and even sharper pain.
3. To diagnose an umbilical hernia, your doctor will give you a physical exam and ask about your full medical history.
4. They will check for any swelling or a sac near your belly button, which is commonly the first sign of an umbilical hernia.

Your doctor will check to see if the hernia has become incarcerated or strangulated. If so, surgery is needed to repair the umbilical hernia. Some tests that your doctor may order to check on this include a () scan, X-ray, or, The only way to repair an umbilical hernia is through surgery.

Do umbilical cord hernias go away?

About Umbilical Hernias – An umbilical hernia is a weakness that develops in the abdominal wall through and around the belly button, called the umbilicus. A bulge or sac containing fat or intestine pushes out through that weakness, sometimes causing an “outie” belly button.

• Most patients with umbilical hernias first notice a belly button bulge or discomfort.
• Over time these hernias can get larger and more uncomfortable as the hernia sac gets pushed out from inside the abdomen.
• Like other hernias, an umbilical hernia in an adult will not go away or get better without treatment.

Umbilical hernias carry the risk of becoming stuck or “incarcerated,” which could cause strong pain, nausea, vomiting, or the inability to pass gas from the rectum. This is an emergency, and if this happens, you should contact your doctor immediately or go to the emergency room.

Can you put breast milk on umbilical cord?

Abstract – Umbilical cord care is variable all over the world and is informed by firm traditional practices that are passed down as culture. Breast milk has been proposed as a topical substance to the umbilicus as it is full of antibacterial properties.

The analysis of four studies revealed a strong correlation between the use of topical breast milk and umbilical cord separation time among newborns in the Middle East. Comparing the results of the studies included in this review, breast milk is not only effective in shortening the separation time of the umbilical cord over dry cord care but is just as effective in reducing signs of infection as the antimicrobial chlorhexidine.

These findings designate breast milk as an affordable, easy, and practical method of umbilical cord care. This is particularly useful in developing countries, where the risk of neonatal death due to infection is higher. The result is generalizable to healthy neonates born in a hospital setting, so more research about its practicality in rural areas as well as among sick neonates is suggested.

What is the most common abnormality of umbilical cord?

2.1. Single umbilical artery – It seems that the first descriptions of the single umbilical artery were made in 1543 by Vesalius in De Humani Corporis, It may be diagnosed with the finding of two vessels on a cross-section of the cord or a vessel seen on only one side of the fetal bladder.

These anomalies appear to be more common when the left umbilical artery is absent and may be associated with aneuploid fetuses and renal anomalies in euploid fetuses. Atresia, aplasia, or agenesis of one artery can lead to single umbilical artery syndrome, Single umbilical artery (SUA) is the most common abnormality of the umbilical cord.

There are three theories about the absence of umbilical artery pathogenesis: (1) primary agenesis of an umbilical artery; (2) atrophy or secondary atresia of the previously normally developed umbilical artery; and (3) persistence of the original allantoic artery of the body stalk,

It is suggested that from the embryological point of view, the second theory would be a reasonable explanation, In single umbilical artery pregnancies, chromosomal abnormalities were found in 8–11% of fetuses, more commonly trisomy 13 and 18 and less frequently trisomy 21, intrauterine growth restriction (IUGR), preterm birth, placental anomalies, and perinatal mortality,

In rare cases, both umbilical arteries are missing and the one arterial vessel is, in fact, a persistent vitelline artery, which branches off the abdominal aorta. This persistent vitelline artery appears to be associated with serious developmental defects and was classified as type II single umbilical artery (type II SUA) by Blackburn and Cooley.

This anomaly accounts for 1.5% cases of single umbilical artery, According to the same authors, the most common form of single umbilical artery (98%) is type I that has one artery and one vein (left), whereas type II SUA has a frequency of 1.5%. Very rare forms are type III with one artery and two veins (left and persistent right umbilical vein) and type IV with one artery and one vein (right).

There is an increased incidence of severe malformations associated with type II SUA with the implication of the caudal body wall (sirenomelia, omphalocele-exstrophy-imperforate anus-spinal defects) and urorectal like exstrophy of the bladder, anal atresia, or urogenital agenesis,

• Among pregnancies with single umbilical artery associated with various malformations, two-thirds of deaths occur before birth.
• Regarding the other third of postnatal deaths, an increased incidence of fetal growth restriction and small placental size was found,
• If no additional chromosomal or structural abnormalities occur, single umbilical artery is defined as an isolated SUA (iSUA), and more than 90% of cases with SUA exhibit an isolated anomaly but without increasing the risk of chromosomal abnormalities,

Regarding adverse pregnancy outcomes and perinatal complications, studies show discordant results. A meta-analysis suggests that there is no significant association between iSUA and pregnancy outcomes, while another meta-analysis suggests that iSUA is associated with a significant increase in adverse perinatal outcomes,

What does an enlarged umbilical cord mean?

What is Umbilical Cord Varix? (Definition/Background Information) –

Umbilical Cord Varix is an abnormal dilatation of the umbilical vein within the umbilical cord. The term ‘varix’ indicates an abnormal enlargement of a blood vesselThe placenta is an organ that connects the developing fetus to the uterine wall. It is a disc shaped reddish brown structure that connects the fetus to the mother through the umbilical cordThe umbilical cord contains two umbilical arteries and one umbilical vein, providing a connection between maternal and fetal blood circulationThe normal function of placenta is to supply nutrients and oxygen to the fetus from the mother’s blood and remove wastes from the fetal bodyUmbilical Cord Varix is a rare condition of unknown cause and with unidentified risk factorsGenerally, no signs and symptoms of Umbilical Cord Varix are observed, either in the mother or in the fetus. However, the condition is linked to spontaneous termination of pregnancy and stillbirthsUmbilical Cord Varix requires prompt and appropriate treatment for an optimal outcome. The prognosis of the condition is generally guardedCurrently, Umbilical Cord Varix is a condition that cannot be prevented

Can umbilical cord correct itself?

Does marginal cord insertion correct itself? – It’s possible. Often, marginal cord insertion doesn’t pose risks to the pregnancy or prevent the fetus from getting enough nutrients. If this is the case, you shouldn’t worry about how the cord is inserted. Instead, trust your provider to monitor the fetus’s development so that you can focus on maintaining your health during pregnancy.

What is an umbilical cyst?

DISCUSSION – Umbilical signs in adults may be suggestive of multiple diseases. However, cystic lesions of the umbilicus generally indicate omphalomesenteric duct or urachal remnants and sebaceous cyst arising from the skin of the umbilicus. Although urachal and omphalomesenteric duct remnants are well described in the literature, sebaceous cyst of the umbilicus was first described in 1995 by Molderez et al.

In a patient with umbilical discharge, In 2002, McClenathan described aseries of seven patientswith a variety of clinical symptoms and signs such as pain, which was radiating in some patients away from the umbilicus, umbilical drainage, a palpable mass or erythema around the umbilicus, Umbilical cyst has been also described as a complication after abdominoplasty due to epidermal inclusion at the site of the umbilicus,

None of the patients of Molderez or McClenathan wereexamined or reported a previous operation around the umbilicus. Sebaceous cyst of the umbilicus is mostly seen in adults, but cases in later childhood, where anomalies due to failure of an embryologic process are most likely seen, have also been published,

McClenathan reported the sebaceous cystswere mostly located above the midline fascia but also described some below the fascia with communication with the skin through a tiny fascial opening, Virmani etal. concluded that a CT scan and MRI can detect the fat and cystic content within a lesion, so benign lesions such as epidermoid cysts and simple lipomas can be differentiated from their malignant counterparts,

The elective excision of asymptomatic umbilical sebaceous cysts is never reported and they are mostly excised when discovered as an incidental finding during examination of inflammatory processes of the umbilicus. Our patient is the first casewhere a sebaceous cyst has been described within the linea alba extending to the umbilicus.

Should I worry about umbilical cord cyst?

Associated abnormalities: –

Single cysts are usually transient with no adverse effect. Multiple cysts are associated with increased risk of miscarriage, trisomies 18 and 13, omphalocele, VACTREL association and fetal growth restriction.

Is umbilical cord risk for infection?

After birth – After a baby is born, a healthcare provider will clamp and cut the umbilical cord. This will leave behind a small umbilical stump, which typically dries up and falls off within the first few weeks of the baby’s life. Sometimes, bacteria can infect the umbilical stump, which is known medically as omphalitis.

increased bleeding from the cord discharge from the cordbad odors coming from the cord redness around the belly button or umbilical cord a rash or blisters on or around the cordfevera baby who does not want to eat, or seems very sleepy sudden changes in the baby’s behavior

Below are some factors that can increase a baby’s risk of developing a UCI:

The baby has a low birth weight.The pregnant woman has chorioamnionitis or another type of infection during birth.The woman’s amniotic membranes rupture 24 hours or more before delivery.The baby is born in unsterile conditions, or a healthcare provider uses an unclean instrument to cut the umbilical cord. Parents or caregivers do not properly care for the umbilical cord stump, for example, if a person pulls off the stump, or gets it dirty.

Any type of infection in a newborn can be an emergency. UCIs require prompt treatment to prevent the risk of complications. A person should call their doctor immediately if their baby develops signs of an infection. If they cannot get in touch with them, a person should take the baby to their nearest emergency room or urgent care center.

symptoms that do not improve within a day or two symptoms that get worsenew symptoms

In most cases, a doctor can treat chorioamnionitis with antibiotics, Sometimes, a woman may need to stay in the hospital or give birth early. A healthcare provider will also monitor the baby for signs of infection before and after birth. Babies who have a UCI will need antibiotics, usually given intravenously.

Depending on how severe the infection is, a doctor may recommend further antibiotic creams or oral medicines. In some cases, a baby will need a hospital stay to complete their treatment. Parents and caregivers should not provide home treatments or pain relievers until they have taken the baby to see a doctor.

These remedies could mask the symptoms of a UCI. They should also not bathe the baby in water until the UCI clears. Instead, they can wash the infant with a clean, damp washcloth or sponge. It is not always possible to prevent chorioamnionitis. However, prompt treatment of infections in pregnant women can reduce the risk.

washing the hands before touching the umbilical cord avoiding the use of unclean instruments to cut the umbilical cord not picking or pulling off the umbilical cordnot placing powders or other home remedies on the cord following your pediatrician’s advice on how to keep the umbilical cord cleanrolling down diapers, so they do not rub against the umbilical cordpaying attention to changes in the shape or appearance of the umbilical cord stump

With proper umbilical cord care, very few babies develop infections. However, it is important to look out for possible signs of a UCI. These include:

rednessincreased bleedingdischarge from the umbilical stumpchanges in the baby’s behavior

Prompt medical treatment can prevent the spread of infection and may save the baby’s life. With timely and appropriate medical care, almost all babies can recover.

How do I keep my umbilical cord healthy?

Cord – umbilical; Neonatal care – umbilical cord The umbilical cord connects the baby to the mother’s placenta. During fetal development in the womb, the umbilical cord is the lifeline to the baby supplying nutrients. After birth, the cord is clamped and cut. Eventually between 1 to 3 weeks the cord will become dry and will naturally fall off. During the time the cord is healing it should be kept as clean and as dry as possible. A sponge bath is the best way to clean your baby until the umbilical cord falls off. To give a sponge bath, dip a soft cloth in the warm water and wring out the excess. If needed, a mild soap can be used in the water. Wipe the baby’s skin gently starting from the area of the baby’s head and work your way down to the rest of the body.

What is a lotus baby?

A lotus birth is the decision to leave your baby’s umbilical cord attached after they are born. The umbilical cord remains attached to the placenta until it dries and falls off by itself. What are the risks of lotus birth? There are no research studies available on this topic.

What is an umbilical granuloma?

An umbilical granuloma is a moist, red lump of tissue that can form on a baby’s navel (belly button). It can be seen in the first few weeks of life, after the umbilical cord has dried and fallen off. It’s usually a minor problem that looks worse than it is.

Is an umbilical cord hernia?

Health LibraryUmbilical Hernia An umbilical hernia is an abnormal bulge that can be seen or felt at the umbilicus (belly button). This hernia develops when a portion of the lining of the abdomen, part of the intestine, and / or fluid from the abdomen, comes through the muscle of the abdominal wall.

What is umbilical phlebitis?

Umbilical phlebitis is the presence of neutrophils in the wall of umbilical vein (stage 1: early; most common histologic finding) Umbilical arteritis is the presence of neutrophils in the wall of 1 or both umbilical arteries (stage 2: intermediate)

What causes umbilical cord granuloma?

The granuloma prevents normal skin tissue developing and may ooze fluid. Umbilical granuloma is the most common umbilical abnormality in newborn babies. The exact cause is unknown but it is related to the tissue healing process. Many umbilical granulomas heal up by themselves and do not need any treatment.

What causes umbilical cord hematoma?

Spontaneous Umbilical Cord Hematoma Monitoring Editor: Alexander Muacevic and John R Adler 1 Department of Pediatrics, Brookdale University Hospital Medical Center, Brooklyn, USA Find articles by 1 Department of Pediatrics, Brookdale University Hospital Medical Center, Brooklyn, USA Find articles by 1 Department of Pediatrics, Brookdale University Hospital Medical Center, Brooklyn, USA Find articles by 2 Department of Pediatrics, Division of Pediatric Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, USA Find articles by 3 Department of Neonatology, Brookdale University Hospital Medical Center, Brooklyn, USA Find articles by © 2021, Khatiwada et al.

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Spontaneous umbilical cord hematoma is a rare complication with a usually benign course but is potentially fatal without vigilant and timely medical intervention.

We present the case of a 23-year-old primigravida mother who presented in labor. She was placed on continuous fetal heart rate monitoring, which showed two episodes of fetal heart rate tracing of the category II variety. The labor was induced with oxytocin, and the ammonitic membrane was incised artificially.

The baby was male, term at 38 weeks, with an appropriate weight, length, and head circumference. There was no gross anomaly or dysmorphic features; the APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score of the baby was 9 and 9 at the first and fifth minutes, respectively. A 4.5 cm hematoma was discovered on the umbilical cord immediately following delivery.

He was admitted to the regular nursery for routine newborn care and was discharged home in stable condition. Spontaneous umbilical cord hematoma is usually due to the rupture of the umbilical vein. Mostly, the umbilical cord hematoma occurs spontaneously and often follows a benign course, however, in some cases, the perinatal loss secondary to umbilical cord hematoma could very high, especially if associated with abnormal fetal heart rate tracing.

Because of the potential for fatality inherent in this condition and to understand the clinical manifestations, risk factors, and eventual course of spontaneous cord hematoma, we present this case to help fellow pediatricians reduce morbidity and mortality associated with it. Keywords: umbilical cord, hematoma, complications Umbilical cord hematoma is defined as the extravasation of blood, mainly venous, in the Warton’s jelly that covers the umbilical vessels,

In about 10% of cases, it could be due to arterial bleeding. It is considered rare, accounting for about one in 5500-11000 living births, Mostly, an umbilical cord hematoma occurs spontaneously and the exact cause is often not detected, However, the cord anomaly (a short cord, traction, knot, prolapse), iatrogenic (amniocentesis, instrumentation), infection, coagulation disorder, and post maturity should be considered as the potential causes,

1. Nevertheless, most hematomas are difficult to be diagnosed by perinatal ultrasonography and when discovered in utero, it requires higher clinical attention as the rate of fetal demise is high,
2. The hematomas could be asymptomatic when they occur in the peripartum period or could present with only abnormal fetal heart rate tracing,

The perinatal loss for umbilical cord hematoma could be as high as 50%, On the other hand, if there is no abnormal tracing of the fetal heart rate, it could be found incidentally after birth and may follow a benign course, Our patient is a 23-year-old primigravida mother who presented to the labor and delivery department with abdominal pain.

She had a history of cervical insufficiency with cervical cerclage placed in the third trimester and was taking daily progesterone. The cerclage was removed the week prior to the presentation. The antenatal labs were insignificant for gonorrhea, chlamydia, Guillain-Barré syndrome (GBS), human immunodeficiency syndrome (HIV), and Hepatitis B.

She denied a history of hypertension, cigarette smoking, or consumption of any illicit substances. Her abdominal pain became progressive but her labor was delayed, requiring augmentation with oxytocin. Epidural anesthesia was given when her pain scale was of moderate intensity (5/10).

Artificial rupture of the membrane was performed six hours prior to birth, which revealed clear amniotic fluid. The continuous fetal heart rate monitoring was placed and showed two episodes of fetal heart rate tracing of category II. The episodes resolved with maternal positioning, and supplemental oxygen to mother at 10 L/min.

The APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score of the baby was 9 and 9 at the first and fifth minutes, respectively. The neonate was assessed by the pediatric team, and the umbilical cord was found to be stained black and red, with a size of 4×3 cm at the point of insertion into the fetal side.

1. The cord was edematous and a cord hematoma was diagnosed (Figures -).
2. The baby was a full-term male with an appropriate weight, length, and head circumference.
3. There were no gross anomaly or dysmorphic features.
4. However, the placenta had clots measuring 4×5 cm (Figure ).
5. The heart rate was regular and no murmur was audible.

There was no active bleeding, hematoma, or bruise from any other side. Umbilical cord hematoma soon after birth Umbilical cord hematoma soon after birth He was admitted to a regular nursery for routine newborn care. He was fed breast milk and was vitally stable with no concern of bleeding from the umbilical hematoma.

• The bilirubin levels at the corresponding age in hours were insignificant.
• The umbilical cord was followed at 36 hours of life, which had dried (Figures -).
• The hematoma had resolved without any complications like bleeding or infection.
• Mother and baby were both discharged within 48 hours of life with an appointment with a primary care doctor scheduled per routine follow-up protocol, which within our institution is two days.

At the office of the primary medical doctor, the complete blood count and bilirubin level were repeated and the labs were insignificant, the umbilical cord was dry, and there was no evidence of hematoma. Umbilical cord after 36 hours of birth Clinical significance Given that this is a rare complication (one in 5500-11000) with a usually benign course but potentially fatal, it is important to be able to perform a thorough examination of the umbilical cord in order to ascertain that it is indeed benign and does not fall into the category of a pathological course in the rare occasion where complications may be present,

1. As we mentioned above, in some, an umbilical hematoma can lead to pathological and even fatal outcomes, including perinatal asphyxia and stillbirth,
2. This means that its etiology ought to be considered and where intragenic causes are present, clinicians ought to work to try to limit the possible complications of procedures.

It is also then of paramount importance to strengthen placental and cord examinations especially in case of unexplained stillbirth or fetal hypoxia. If the hematoma occurs, the peripartum could be asymptomatic and could present with only abnormal fetal heart rate tracing,

If abnormal heart rate tracing is present, an emergent C-section should be performed to save potential fetal loss. In certain cases, the etiology of the hematoma can be a ruptured vein. The ruptured vein can be spontaneous, secondary to the alteration and inflammation of the vessel wall, or secondary to in-utero instrumentations from amniocentesis, fetal transfusions, and fetal diagnostic procedures,

The change in the architecture of the vessels leading to the hematoma is then thought to impede blood flow through the surrounding vessels, possibly resulting in fetal asphyxia and possible demise, It is important to note that though the spontaneous rupture of umbilical vessels cannot be controlled, clinicians can control the secondary causes resulting in umbilical hematomas by exercising more caution with amniocentesis and other diagnostic fetal procedures in order to avoid vessel insult, possible rupture, and resulting hematoma.

Ethically and from a medico-legal standpoint, clinicians ought to list umbilical hematomas as possible complications of amniocentesis and other diagnostic fetal procedures so as to give full and comprehensive informed consent in order to protect both the patient and themselves. In our case, it seemed that none of the earlier described etiological factors were involved except the cerclage, which was not invasive enough to cause a hematoma on the fetal side of the cord.

In addition, no trauma occurred during labor, making it likely a spontaneous phenomenon. A spontaneous umbilical cord is a rare condition and usually occurs due to the rupture of the umbilical vein. Mostly, the umbilical cord hematoma occurs spontaneously and often follows a benign course; however, in some cases, the perinatal loss secondary to an umbilical cord hematoma could be as high as 50%.

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Consent was obtained or waived by all participants in this study. IRB Committee at Brookdale University Hospital Medical Center (BUHMC) issued approval 2021-01 1. Spontaneous umbilical cord hematoma: an unusual cause of fetal mortality: a report of 3 cases and review of the literature. Gualandri G, Rivasi F, Santunione AL, Silingardi E.

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