• Umbilical Cord Prolapse

    Definition

    The umbilical cord connects the fetus to the placenta, an organ that provides nutrition and oxygen to the fetus. Umbilical cord prolapse occurs when the umbilical cord passes through the birth canal and into the vagina in front of the baby's head. It occurs after the membranes have ruptured.
    As the baby passes through the birth canal during labor, it puts pressure on the prolapsed umbilical cord. This compression of the umbilical cord decreases or can completely cut off blood flow and oxygen to the baby.
    Umbilical cord prolapse is a dangerous condition that can cause stillbirth unless the baby is delivered quickly, usually by cesarean section (C-section). Most babies delivered quickly through cesarean section do not suffer from complications caused by this condition.
    Umbilical Cord Prolapse
    Prolapsed Umbilical cord
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Umbilical cord prolapse is cause by the umbilical cord coming out of the uterus before the baby's head.

    Risk Factors

    Factors that increase your chance of umbilical cord prolapse:
    • Having a baby that is in the breech position
    • Premature rupture of the membranes
    • Having multiple births in one pregnancy
    • Having an unusually long umbilical cord
    • Having too much amniotic fluid around the fetus—polyhydramnios
    • Artificial rupture of the membranes

    Symptoms

    Drastic changes in the fetal heart rate during labor can signal the doctor to check for a prolapsed umbilical cord.

    Diagnosis

    Seeing or feeling the umbilical cord in the vagina before the baby's delivery during a pelvic exam confirms that diagnosis.

    Treatment

    Treatment options include:
    • Delivery by C-section—If the baby cannot be quickly delivered vaginally.
    • Removing pressure from the cord—In some cases, the doctor may be able to move the baby away from the cord so as not to cut off oxygen supply to the baby. The mother may also be asked to move into a position that removes pressure from the cord and protects the baby.
    • Rapid delivery—If the mother is ready to deliver, the doctor may try to deliver the baby very quickly using forceps or a vacuum extractor.
    Cesarean Delivery
    Cesarean Delivery
    Copyright © Nucleus Medical Media, Inc.

    Prevention

    There are no current guidelines to prevent umbilical cord prolapse.

    RESOURCES

    American Pregnancy Association http://www.americanpregnancy.org

    The American Congress of Obstetricians and Gynecologists http://www.acog.org

    CANADIAN RESOURCES

    The Canadian Women's Health Network http://www.cwhn.ca

    The Society of Obstetricians and Gynaecologists of Canada (SOGC) http://sogc.org

    References

    Holbrook BD, Phelan ST. Umbilical cord prolapse. Obstet Gynecol Clin North Am. 2013;40(1):1-14.

    Umbilical cord prolapse. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900149/Umbilical-cord-prolapse. Updated December 15, 2014. Accessed September 28, 2016.

    Revision Information

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