Umbilical cord prolapse: Difference between revisions

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'''Umbilical cord prolapse''' is a complication that occurs during pregnancy when the [[umbilical cord]] drops (prolapses) through the open [[cervix]] into the [[vagina]] ahead of the baby. This can happen during labor or before labor starts. The prolapsed cord can then become trapped against the baby's body during delivery. This can cause a decrease in the blood flow to the baby, which can result in serious complications.
{{SI}}
 
{{Infobox medical condition
==Causes==
| name            = Umbilical cord prolapse
Umbilical cord prolapse can be caused by several factors. These include:
| image          = [[File:Cord.prolaps.jpg|left|thumb|Umbilical cord prolapse]]
 
| caption        = Umbilical cord prolapse during labor
* Premature rupture of membranes ([[PROM]]): This is when the amniotic sac breaks before labor starts.
| field          = [[Obstetrics]]
* Long umbilical cord: The average length of the umbilical cord is 50-60 cm. A longer cord increases the risk of prolapse.
| synonyms        = Cord prolapse
* Abnormal fetal presentation: This includes breech presentation (where the baby is positioned feet or buttocks first) and transverse lie (where the baby is positioned horizontally).
| symptoms        = [[Fetal distress]], visible or palpable cord at the [[vagina]]
* Multiple pregnancy: Having twins or more increases the risk of cord prolapse.
| complications  = [[Fetal hypoxia]], [[fetal death]]
* Excessive amniotic fluid ([[polyhydramnios]]): This can cause the cord to slip ahead of the baby.
| onset          = [[Labor (childbirth)|Labor]]
 
| duration        = Until delivery
==Symptoms==
| causes          = [[Premature rupture of membranes]], [[polyhydramnios]], [[multiple gestation]]
The main symptom of umbilical cord prolapse is a sudden decrease in the baby's heart rate. Other symptoms can include:
| risks          = [[Breech presentation]], [[transverse lie]], [[preterm birth]]
 
| diagnosis      = [[Physical examination]], [[fetal heart rate monitoring]]
* Feeling or seeing the umbilical cord in the vagina
| differential    = [[Cord presentation]], [[vasa previa]]
* Abnormal fetal heart rate
| prevention      = Avoiding [[artificial rupture of membranes]] in high-risk cases
* Rapid maternal pulse
| treatment      = [[Emergency cesarean section]], manual elevation of the presenting part
* Severe abdominal pain
| prognosis      = Depends on promptness of delivery
 
| frequency      = 0.1% to 0.6% of deliveries
==Diagnosis==
}}
Umbilical cord prolapse is usually diagnosed during labor. The healthcare provider may suspect cord prolapse if there is a sudden decrease in the baby's heart rate. A physical examination can confirm the diagnosis.
[[File:Herself;_talks_with_women_concerning_themselves_(1911)_(14781210692).jpg|left|thumb|Historical depiction of childbirth]]
 
'''Umbilical cord prolapse''' is an obstetric emergency that occurs when the [[umbilical cord]] slips ahead of the presenting part of the fetus and protrudes into the [[vagina]] or beyond, potentially leading to compromised blood flow to the fetus. This condition requires immediate medical intervention to prevent fetal hypoxia and other complications.
==Treatment==
== Causes ==
Umbilical cord prolapse is a medical emergency. The goal of treatment is to relieve pressure on the cord until delivery can be achieved. This can be done by:
Umbilical cord prolapse can occur due to several factors, including:
 
* [[Premature rupture of membranes]]
* Changing the mother's position
* [[Polyhydramnios]] (excessive amniotic fluid)
* Filling the bladder with fluid to elevate the presenting part
* [[Multiple pregnancy]]
* Delivering the baby as quickly as possible, usually by emergency [[cesarean section]]
* Abnormal fetal presentation, such as [[breech presentation]]
 
* Long umbilical cord
==Prognosis==
== Diagnosis ==
The prognosis for umbilical cord prolapse depends on how quickly the condition is diagnosed and treated. With prompt treatment, most babies recover fully. However, if treatment is delayed, the baby can suffer from lack of oxygen, which can lead to brain damage or death.
Diagnosis of umbilical cord prolapse is typically made during a [[pelvic examination]] when the cord is felt or seen in the vagina. It may also be suspected if there is a sudden change in the fetal heart rate pattern, such as [[bradycardia]] or variable decelerations.
 
== Management ==
==See also==
Immediate management of umbilical cord prolapse involves:
* [[Obstetric emergencies]]
* Repositioning the mother to relieve pressure on the cord, such as the [[knee-chest position]] or Trendelenburg position.
* [[Complications of pregnancy]]
* Manual elevation of the presenting fetal part to reduce cord compression.
* [[Umbilical cord]]
* Emergency [[cesarean section]] to deliver the baby as quickly as possible.
 
== Prognosis ==
The prognosis for umbilical cord prolapse depends on the speed of diagnosis and intervention. Prompt delivery can prevent serious complications, but delays can lead to fetal distress, hypoxia, or even stillbirth.
== Prevention ==
Preventive measures include careful monitoring of high-risk pregnancies and avoiding unnecessary rupture of membranes when the fetal head is not engaged.
== See also ==
* [[Obstetrics]]
* [[Fetal distress]]
* [[Cesarean section]]
== References ==
{{Reflist}}
[[Category:Obstetrics]]
[[Category:Obstetrics]]
[[Category:Medical emergencies]]
[[Category:Medical emergencies]]
[[Category:Complications of labour and delivery]]
{{stub}}

Latest revision as of 14:36, 9 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Umbilical cord prolapse
Umbilical cord prolapse
Synonyms Cord prolapse
Pronounce N/A
Specialty N/A
Symptoms Fetal distress, visible or palpable cord at the vagina
Complications Fetal hypoxia, fetal death
Onset Labor
Duration Until delivery
Types N/A
Causes Premature rupture of membranes, polyhydramnios, multiple gestation
Risks Breech presentation, transverse lie, preterm birth
Diagnosis Physical examination, fetal heart rate monitoring
Differential diagnosis Cord presentation, vasa previa
Prevention Avoiding artificial rupture of membranes in high-risk cases
Treatment Emergency cesarean section, manual elevation of the presenting part
Medication N/A
Prognosis Depends on promptness of delivery
Frequency 0.1% to 0.6% of deliveries
Deaths N/A


Historical depiction of childbirth

Umbilical cord prolapse is an obstetric emergency that occurs when the umbilical cord slips ahead of the presenting part of the fetus and protrudes into the vagina or beyond, potentially leading to compromised blood flow to the fetus. This condition requires immediate medical intervention to prevent fetal hypoxia and other complications.

Causes[edit]

Umbilical cord prolapse can occur due to several factors, including:

Diagnosis[edit]

Diagnosis of umbilical cord prolapse is typically made during a pelvic examination when the cord is felt or seen in the vagina. It may also be suspected if there is a sudden change in the fetal heart rate pattern, such as bradycardia or variable decelerations.

Management[edit]

Immediate management of umbilical cord prolapse involves:

  • Repositioning the mother to relieve pressure on the cord, such as the knee-chest position or Trendelenburg position.
  • Manual elevation of the presenting fetal part to reduce cord compression.
  • Emergency cesarean section to deliver the baby as quickly as possible.

Prognosis[edit]

The prognosis for umbilical cord prolapse depends on the speed of diagnosis and intervention. Prompt delivery can prevent serious complications, but delays can lead to fetal distress, hypoxia, or even stillbirth.

Prevention[edit]

Preventive measures include careful monitoring of high-risk pregnancies and avoiding unnecessary rupture of membranes when the fetal head is not engaged.

See also[edit]

References[edit]

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