Umbilical Cord Prolapse

  • Definition

    The umbilical cord connects the fetus to the placenta, an organ that provides nutrition. 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 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
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  • 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 getting umbilical cord prolapse include:
    • Having a baby that is in the breech position
    • Premature rupturing of the membranes
    • Having multiple births in one pregnancy
    • Having an unusually long umbilical cord
    • Having too much amniotic fluid around the fetus
    • Artificial rupture of membranes
  • Symptoms

    Seeing or feeling the umbilical cord in the vagina before the baby's delivery is a symptom of umbilical cord prolapse.
  • Diagnosis

    The diagnosis is made when a pelvic examination is done to see and feel the umbilical cord present in the vagina in front of the baby's head.
  • 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
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  • Prevention

    There are no current guidelines to prevent umbilical cord prolapse.
  • RESOURCES

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

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

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health http://www.womenshealthmatters.ca

    References

    Catanzarite VA. The two-vessel cord: how concerned should we be? Contemporary Ob/Gyn. 1997;43-54.

    Dildy GA, Clark SL. Umbilical cord prolapse. Contemporary Ob/Gyn. 1993;23-31.

    Lee W, et al. Vasa previa: prenatal diagnosis, natural evolution, and clinical outcome. Obstet Gynecol. 2000;95(4):572-576.

    Levy H, Meier P, et al. Umbilical cord prolapse. Obstet Gynecol. 1984;64(4):499-502.

    Umbilical cord prolapse. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated November 22, 2011. Accessed June 5. 2013.

    Umbilical cord prolapse. The Cleveland Clinic Health Information Center website. Available at: http://www.clevelandclinic.org/health/health-info/docs/3800/3870.asp?index=12345. Accessed June 5, 2013.

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