Hypoxic ischemic encephalopathy (HIE) is a leading cause of neonatal death and long-term disability. HIE occurs when the brain does not get a sufficient supply of blood or oxygen. A hypoxic event can occur before or during labor.

Some people may ask what is the purpose of the umbilical cord? As a fetus forms and develops, the cord becomes the baby’s lifeline. It is a conduit between the mom and the baby. The cord usually has three blood vessels: two arteries and one vein.  The umbilical vein supplies the baby with nutrient enriched blood that has been oxygenated. The umbilical artery carries the “used” blood back to the placenta and back to the mother to be dispelled.

In some pregnancies, there may only be two vessels: one artery and one vein. This counts for a small number of pregnancies and most of the pregnancies are not distressed by only having one artery. In a small percentage of these two vessel cord pregnancies, the two vessels may be a sign of abnormalities. The number of cord vessels can be determined during the first trimester.


You can now see what the umbilical cord’s primary function. So, what happens if there is a problem with the cord or if the umbilical cord becomes compromised in some way? There are a few issues that can occur with an umbilical cord that can not only cause devastating injury to a baby, but also could cause the baby’s death.

One complication that could arise is umbilical cord compression. An umbilical cord compression occurs when there is pressure on the cord that seriously reduces the cord’s ability to allow blood, oxygen, and nutrients to freely flow to the baby.

The compression of the umbilical cord can be caused by cord prolapse (cord being delivered before the baby during a vaginal delivery), nuchal cord (when the cord completely encircles the baby’s neck), or a knotted cord (cord actually has a knot in it). Additionally, abnormal levels of amniotic fluid can have an impact on cord compression. For example, if there is not enough fluid then the baby may not have enough support while in utero. This can cause the cord to move around too freely. Too much amniotic fluid can cause premature water breaking which increases the chance of cord prolapse.


Once complications with the umbilical cord are observed, doctors must determine the best course of treatment. Types of treatment will depend upon the gestational age of the baby and how close the mother is to labor.

If doctors and nurses do not move quickly enough to relieve the pressure on the umbilical cord, the baby could suffer severe oxygen and blood deprivation. If the baby does not receive enough blood or oxygen, he or she could suffer a permanent brain injury which could lead to a diagnosis of HIE. Cerebral palsy could also occur if the baby does not receive enough blood and oxygen through the umbilical cord.

This article is one of the examples of how a problem with the umbilical cord can impact the baby’s ability to receive enough blood and oxygen to his/her brain and the resulting diagnoses that can occur.

Your friends at HIE Resource Place.