Umbilical Cord Prolapse (Symptoms,Causes and Treatment)

When the umbilical cord descends through the cervix prior to the baby’s head, pressure is placed on the chord and the baby’s access to oxygen and nutrition may be compromised. Umbilical cord prolapse is an uncommon but significant obstetric emergency. This situation can happen during labor and delivery, and it is more frequent when the mother has a low-lying placenta or the baby is in an unusual position.

Untreated umbilical cord prolapse can result in fetal suffering and even death, thus it needs to be addressed right away by a doctor. Altering the mother’s posture, giving extra oxygen, giving intravenous fluids, and potentially performing an emergency cesarean section to deliver the child are all possible treatment options. The risk of problems is reduced and risk factors for umbilical cord prolapse are identified through prenatal treatment and surveillance.

This article covers the following topics :

Umbilical cord prolapse: what is it?

A rare yet deadly obstetric emergency that can happen during labor and delivery is umbilical cord prolapse. The umbilical cord becomes crushed between the baby’s head and the mother’s pelvis when it descends through the cervix before the baby’s head. This may put strain on the umbilical cord and obstruct the baby’s access to oxygen and nutrition.

The placenta, which supplies oxygen and nutrition to the growing fetus, is connected to the developing fetus through the umbilical cord, which serves as a lifeline. When the umbilical cord is constricted during childbirth, the baby’s blood and oxygen supply can be cut off, causing fetal distress and possibly even brain damage or fetal death.

When the infant is breech (feet first) or transverse (sideways), or when the mother has a low-lying placenta (placenta previa), umbilical cord prolapse is more likely to occur. It can also happen when there is an excessive amount of amniotic fluid (polyhydramnios) or when the baby’s membranes prematurely burst.

Umbilical cord prolapse is characterized by abrupt, severe fetal heart rate slowing, visible or palpable cord prolapse, and variations in the tone or color of the amniotic fluid. To reduce the risk of problems, prompt medical intervention is needed if umbilical cord prolapse is suspected.

Umbilical cord prolapse is typically treated by moving the mother’s position to relieve pressure on the cord, giving the mother and baby extra oxygen, giving her intravenous fluids to help control her blood pressure, and possibly performing an emergency cesarean section to deliver the baby.

Monitoring the baby’s position throughout pregnancy and birth, avoiding procedures that can prematurely rupture the membranes, and checking the amniotic fluid level to make sure it is within normal range are all steps in the prevention of umbilical cord prolapse.

In conclusion, umbilical cord prolapse is an uncommon but significant obstetric emergency that needs to be treated right away. If not addressed right once, it may cause fetal distress and even result in brain damage or fetal death. Umbilical cord prolapse can be avoided, reducing the risk of complications, with early risk factor identification and diligent monitoring during labor and delivery.

The umbilical chord is what?

The flexible cord-like umbilical chord, which connects the developing fetus to the placenta in the uterus of a pregnant woman, is responsible for this connection. It has a single vein and two arteries, both of which are encircled with Wharton’s jelly. The umbilical cord provides the developing fetus with oxygen, nutrition, and waste removal from the mother’s blood supply, acting as a lifeline. At full gestation, the umbilical chord is normally between 50 and 60 centimeters long. It is usually clamped and removed after the infant is born.

How does the umbilical cord prolapse proceed?

The fetus may suddenly encounter a reduction in blood and oxygen flow when the umbilical cord prolapses, which can result in fetal discomfort. The baby’s heart rate may drop suddenly as a result, which can be seen by electronic fetal monitoring. If treated quickly, severe cases of the lack of oxygen and blood flow might result in brain damage or fetal death.

The mother may not feel any umbilical cord prolapse symptoms, or she may suddenly feel pressure or notice a palpable or visual prolapse of the chord. To reduce the risk of problems, prompt medical intervention is needed if umbilical cord prolapse is suspected.

What kinds of umbilical cord prolapse are there?

Umbilical cord prolapse can occur in one of two ways:

1-Occult umbilical cord prolapse: In this condition, the umbilical cord protrudes forward of the fetus’s visible portion but stays inside the delivery canal. Even while it may not show any symptoms or be difficult to detect, it can nevertheless result in cord compression and restricted blood flow to the fetus.

2-Overt umbilical cord prolapse: In this condition, the umbilical cord prolapses from the vagina prior to the fetus and is palpable or apparent. This is a medical emergency that needs to be attended to right once to reduce the danger of consequences.

How prevalent is this illness?

Umbilical cord prolapse is an uncommon disease that affects 0.1-0.6% of births. Breech presentation, repeated pregnancies, preterm births, and polyhydramnios (excessive amniotic fluid) all increase the risk of umbilical cord prolapse. Umbilical cord prolapse, though it is a relatively uncommon problem, can have devastating effects on both the mother and the infant and necessitates rapid medical care.

What umbilical cord prolapse symptom is most typical?

A abrupt and sustained drop in the fetal heart rate, which can be picked up by electronic fetal monitoring, is the most typical sign of umbilical cord prolapse. This is due to the possibility that the umbilical cord could become crushed between the baby’s head and the mother’s pelvis, which would reduce the baby’s supply of oxygen and blood. The mother might occasionally also feel pressure in the vaginal area or see a visible or palpable prolapse of the cord. Umbilical cord prolapse, on the other hand, frequently goes undetected until it is discovered by chance during labor or delivery. Umbilical cord prolapse is an uncommon but significant obstetric emergency that needs to be treated right once to reduce the risk of sequelae.

What causes prolapse of the umbilical cord?

During labor or delivery, umbilical cord prolapse happens when the cord slides past the cervix and emerges in front of the fetal head. Umbilical cord prolapse is made possible by a number of circumstances, including:

1-Premature membrane rupture: An early rupture of the amniotic sac can lead to the umbilical cord slipping through the cervix and constricting.

2-Breech presentation: The umbilical cord is more likely to become crushed between the baby’s head and the mother’s pelvis when the baby is in a breech posture.

3-Multiple pregnancies: The risk of umbilical cord prolapse is greater when there are twins, triplets, or other multiple pregnancies.

4-Polyhydramnios: An excessive amount of amniotic fluid might make the umbilical cord prolapse more likely.

5-Fetal macrosomia: The risk of the umbilical cord being squeezed during labor and delivery is higher when the baby is larger than typical.

6-Placenta previa: The umbilical cord may slide through the cervix and become squeezed when the placenta is in the lower portion of the uterus.

7-Abnormal fetal presentation: The risk of umbilical cord prolapse is increased when the infant presents shoulder-first or face-first rather than head-first.

Umbilical cord prolapse is a rare but significant complication that can happen even in the absence of these risk factors, it is vital to highlight.

Who is susceptible to prolapse of the umbilical cord?

Any pregnancy can experience umbilical cord prolapse, however specific circumstances may make it more likely. These risk elements consist of:

1-Premature rupture of the membranes (PROM): The risk of umbilical cord prolapse increases if the amniotic sac ruptures before to the start of labor.

2-Abnormal fetal presentation: There is an increased chance of cord prolapse if the infant is in a breech position, transverse lay (lying sideways), or any other non-head first posture.

3-Multiple gestations: Pregnancies with more than one child, such as twin pregnancies, increase the risk of umbilical cord prolapse.

4-Polyhydramnios: The risk of cord prolapse is raised by this condition’s high amniotic fluid buildup.

5-Fetal macrosomia: The risk of cord prolapse is increased if the fetus is larger than typical.

6-Placenta previa: There is a higher risk of cord prolapse when the placenta is positioned low in the uterus and blocks the cervical opening.

It’s crucial to remember that umbilical cord prolapse is a rare but significant pregnancy and birthing problem that needs to be treated right away to reduce the risk of complications.

What problems can arise from an umbilical cord prolapse?

A dangerous obstetric emergency called umbilical cord prolapse can have serious consequences for both the mother and the unborn child. Umbilical cord prolapse may result in a number of potential issues, such as:

1-Fetal distress: When the umbilical cord is compressed, the infant may receive less oxygen and blood, which could result in fetal distress and lasting brain damage.

2-Stillbirth: If the umbilical chord prolapses severely, the infant may not survive.

3-Infection: There is an increased risk of infection for both the mother and the child if the amniotic sac ruptures prior to the start of labor.

4-Emergency cesarean section: In the majority of cases with umbilical cord prolapse, a rapid delivery of the infant is required in order to reduce the risk of complications.

5-Admission to the neonatal intensive care unit (NICU): If the infant develops fetal distress or other issues connected to umbilical cord prolapse, they may need to be admitted to the NICU for observation and care.

The risk of consequences must be kept to a minimum by receiving urgent medical assistance for umbilical cord prolapse, a rare but significant condition. Any worries or inquiries regarding umbilical cord prolapse should be brought up with the pregnant woman’s healthcare professional.

What are the early indications of prolapsed umbilical cord?

A abrupt drop in the fetal heart rate that can be picked up by electronic fetal monitoring is frequently the first indication of umbilical cord prolapse. This may occur as a result of decreased oxygen and blood flow to the infant caused by the prolapsed cord becoming pinched between the baby’s head and the mother’s pelvis.

The mother might occasionally also feel pressure in the vaginal area or see a visible or palpable prolapse of the cord. This could happen before, during, or following an amniotic sac rupture. The umbilical cord may occasionally be visible outside of the vagina.

Umbilical cord prolapse is an uncommon but significant obstetric emergency that needs to be treated right once to reduce the risk of sequelae. A pregnant woman should seek medical assistance right away if she has any of these signs or thinks she could have a prolapsed cord.

How is a prolapsed umbilical cord treated?

In order to reduce the danger of consequences, umbilical cord prolapse is a medical emergency that needs to be treated right once. The severity of the condition and the health of the mother and child will determine the exact course of treatment for umbilical cord prolapse. Umbilical cord prolapse may be treated using a variety of methods, including:

1-Immediate delivery: To reduce the risk of problems, the infant should be delivered right away in the majority of cases of umbilical cord prolapse. Depending on the situation, this can include a quick vaginal delivery or an emergency cesarean section.

2-Repositioning: If a cord prolapse is found prior to the start of labor, the woman may be told to adjust her position in an effort to release the chord’s pressure. In some circumstances, this might aid in halting additional cord prolapse.

3-Oxygen therapy: This treatment can help the baby’s oxygen levels and reduce the risk of brain damage if the baby is in fetal distress as a result of umbilical cord compression.

4-Monitoring: To make sure the mother and child are stable and unaffected by difficulties caused by umbilical cord prolapse, they will both be continuously watched during and after delivery.

Remember that umbilical cord prolapse is a rare but significant obstetric emergency that needs to be treated right away. A pregnant woman should seek medical assistance right away if she thinks she might have a prolapsed cord.

Is it possible to stop umbilical cord prolapse?

Even because umbilical cord prolapse cannot always be avoided, pregnant women can take several precautions to lower their risk. These consist of:

1-Regular prenatal care can assist healthcare professionals in identifying and managing any risk factors for umbilical cord prolapse.

2-Avoiding needless interventions: Using forceps or vacuum extraction during delivery or artificially rupturing the amniotic sac can both increase the risk of umbilical cord prolapse.

3-Positioning during giving birth: In some circumstances, giving birth in a different position (such as kneeling or squatting) or switching positions during labor may assist prevent umbilical cord prolapse.

4-Avoid pushing too forcefully or for too long: During labor, pushing too hard or for too long can raise the chance of umbilical cord prolapse. Pregnant women should push during labor according to their doctor’s instructions.

5-Timely delivery: A timely birth can help reduce the risk of umbilical cord prolapse, particularly in cases of high-risk pregnancies or premature labor.

It’s crucial to remember that while taking these precautions may help lower the chance of umbilical cord prolapse, this problem cannot always be avoided. Any worries or inquiries regarding umbilical cord prolapse should be brought up with the pregnant woman’s healthcare professional.

A chord prolapse: Can a baby survive it?

Yes, a newborn can survive a cord prolapse if they receive timely and appropriate medical care. The degree of the prolapse, the amount of time the infant remained without oxygen, the promptness and efficacy of the medical measures, and other factors all affect the outcome.

In order to reduce the danger of problems, umbilical cord prolapse is a major obstetric emergency that needs to be treated right once. A prolapsed cord can occasionally induce fetal distress or hypoxia, which, if not properly addressed, can result in brain damage or even fetal death. However, many infants who undergo a cord prolapse can survive without experiencing any long-term problems with prompt delivery and the right medical measures.

Pregnant women should go to their regularly scheduled prenatal care sessions and seek emergency medical help if they encounter any umbilical cord prolapse symptoms, such as abrupt fetal distress or a visible or palpable cord prolapse. Both the mother and the unborn child have a better chance of a successful outcome with early diagnosis and rapid treatment.