Umbilical cord prolapse

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.

Causes

Umbilical cord prolapse can be caused by several factors. These include:

• Premature rupture of membranes (PROM): This is when the amniotic sac breaks before labor starts.
• Long umbilical cord: The average length of the umbilical cord is 50-60 cm. A longer cord increases the risk of 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).
• Multiple pregnancy: Having twins or more increases the risk of cord prolapse.
• Excessive amniotic fluid (polyhydramnios): This can cause the cord to slip ahead of the baby.

Symptoms

The main symptom of umbilical cord prolapse is a sudden decrease in the baby's heart rate. Other symptoms can include:

• Feeling or seeing the umbilical cord in the vagina
• Abnormal fetal heart rate
• Rapid maternal pulse
• Severe abdominal pain

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.

Treatment

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:

• Changing the mother's position
• Filling the bladder with fluid to elevate the presenting part
• Delivering the baby as quickly as possible, usually by emergency cesarean section

Prognosis

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.

See also

• Obstetric emergencies
• Complications of pregnancy
• Umbilical cord

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