The umbilical cord

The umbilical cord (synonym umbilical cord) - part of the placenta in the form of a spiral twisted cord connecting the fetus to the placenta. The length of the cord 50-60 cm, thickness 1,5-2 cm; the umbilical cord consists of gelatinous connective tissue (see Vartanova jelly). In the umbilical cord are two arteries and one vein, in which fetal-placental circulation.
To the pathology umbilical include: shortening or excessive length of it, previste attaching the umbilical cord (attached to the shell at a distance of 10-15 cm from the edge of the placenta, rupture of the umbilical cord, inflammation of the umbilical cord tumors and cysts of the umbilical cord. In the long umbilical cord is often the entanglement around the neck, limbs, trunk of a fetus, true nodes of the umbilical cord, twist, a presentation and a cord prolapse.

the cutting of the umbilical cord
Fig. 1. The cutting of the umbilical cord between the two clips.

Fig. 2. The imposition of the bracket on the umbilical cord. Left - right, right - wrong: 1 - skin edge of the umbilical ring; 2 - imposed bracket; 3 - line cut the umbilical cord; 4 - the umbilical cord.

After birth the fetus scissors cross the umbilical cord between the two terminals, imposed at a distance of 10 and 15 cm from the umbilical ring (Fig. 1), and the newborn separated from the placenta. After re-treatment of hands impose final ligature on the border with umbilical ring and at a distance of 1.5-2 cm above the ligature cut off the stump. Before the umbilical cord transection wipe 95% alcohol or 5% iodine tincture. Stump grease with iodine, then gently squeeze sterile cotton wool soaked in 95% ethanol, once again grease with iodine and impose on it a sterile cloth, folded in four. Other sterile cloth, folded scarf, put the top and tied a knot on the border between the umbilical ring and the end of the umbilical stump.
Methods ligation of the umbilical cord is very diverse. The most common and reliable method is Century. E. Rogovina - overlay on the umbilical cord metal bracket (Fig. 2) with the help of pliers. The bracket from tin-plated chrome-plated tin lay at a distance of 0.2-0.5 cm from the skin ring umbilical cord cut the umbilical cord 2 cm above the brackets, the remainder is treated with a 5% solution of potassium permanganate. Wrap P. should not be. In the future the stump and adjacent to it part of the skin of the abdomen is treated once a day 5-6% solution of potassium permanganate, until the umbilical residue will not disappear (usually 4-5 days). After that the wound daily treated 60-70% alcohol or potassium permanganate solution. Umbilical wound heals in 2-3 days.
Method of omphalotripsy - crushing umbilical angiodema or other tool with a strong clamp is now rarely used.

The umbilical cord, or the umbilical cord (funiculus umbilicalis), is survenue education, connecting the placenta to the fetus, in length of 50-60 cm, thickness is 1.5-2 cm from Outside the umbilical cord covered with water jacket, which is Vartanova jelly (see) with rare stellate cells. In some places the umbilical cord are thickening, so-called false nodes, the resulting congestion in these areas Vartanova studeni or tightening the umbilical arteries. The entire length of the umbilical cords are pulled two umbilical artery and the umbilical vein. In the umbilical veins found folds, forming duplicatura inner shell like valves, and in the lumen of the arteries - ring bulging walls like cushions. These education contribute to the cessation of bleeding from the umbilical cord when not tied. Some authors found nervous stem, stretching along the vessels. Nerve cells are also found at the level of attachment of the umbilical cord to the placenta (they, apparently, are involved in regulating blood circulation between the fetus and the placenta).
With 6-7-th week of pregnancy in Vartanova studeni proceed active hematopoiesis (formed blood islets and a dense network of blood capillaries). They are referred to the type of adventitious vascular, believing that they can be a source of hemorrhage into the fabric of Vartanova studeni.

Numerous methods of crossing and ligation of the umbilical cord aim at possibly more favorable return development of the umbilical stump, early cessation and prevention of infection navel. A special tool for putting on the umbilical cord after crossing rubber rings Kuzmin.
By analogy with surgical practice was proposed crushing of the umbilical cord (omphalotripsy) angiodema or other tool with a strong clamp (omphalitis), which could be left to the newborn 3-4 hours (for example, tweezers Thief). To this end you can apply normal clip Kocher (small size, with cut teeth); when imposing clamp his ring addressed to the chest. Close to omphalotripsy method Rogovina - overlay on the umbilical cord metal brackets (like surgical brackets Michel imposed on skin wound) special forceps. Instead of special brackets Rogovina offered after crushing P. Kocher forceps to impose on opposite sides two conventional surgical brackets. For the fastest mummification umbilical stump more profitable to put a bracket close as possible to the umbilical ring; not to capture Meckel's ganglion diverticulum or urachus recommend before imposing brackets to see P. against the light source, especially when the ligature on the umbilical cord impose directly from the umbilical ring.
To accelerate mummification umbilical stump it is treated with gypsum, potassium permanganate, tannin, a solution of sodium chloride, alcohol. Before crossing the umbilical cord prompted to enter in Vartanova jelly solution of sodium salt of penicillin (100 000 IU) in 5 ml of physiological solution. The umbilical stump impose sterile bandage, often method Chistyakova: take two square gauze napkins length of 10-12 cm; one sheet imposed directly on the umbilical stump, and the other, folded solitaire (triangle), tied at the border of the umbilical ring and stump.
There is a method of care of funic remnant without dressing. Before crossing the umbilical cord does not processed; some distance by 1 - 1.5 cm from the skin ring on the cord impose silk ligature, one above the other, and cross it between them; until the falling away of the umbilical residue is no treatment is not exposed; newborn in the first day swaddled in a sterile diaper. With this method the remainder of the Isthmus is natural conditions and faster modificeres; when imposing of a bandage latter easily wetted urine, which prevents the development of dry gangrene of the umbilical.
Promising introduction in umbilical blood vessels and medications in therapy of different pathological conditions of the newborn. In severe forms of asphyxia newborns enter hypertonic solutions of calcium chloride and glucose, or blood in the umbilical artery. The blood is injected under the changing pressure from 60-100 up to 220 mm RT. senior Umbilical vein is used to exchange blood transfusion infants with erythroblastosis; this method is much easier and more effective than the introduction in the peripheral blood vessels.