Umbilical cord prolapse

Umbilical Cord Prolapse

Illustration of umbilical cord prolapse

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

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

• Premature rupture of membranes
• Polyhydramnios (excessive amniotic fluid)
• Multiple pregnancy
• Abnormal fetal presentation, such as breech presentation
• Long umbilical cord

Diagnosis

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

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

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.

Related Pages

• Obstetrics
• Fetal distress
• Cesarean section