Umbilical cord prolapse

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Umbilical cord prolapse
Umbilical cord prolapse
Synonyms	Cord prolapse
Pronounce	N/A
Specialty	N/A
Symptoms	Fetal distress, visible or palpable cord at the vagina
Complications	Fetal hypoxia, fetal death
Onset	Labor
Duration	Until delivery
Types	N/A
Causes	Premature rupture of membranes, polyhydramnios, multiple gestation
Risks	Breech presentation, transverse lie, preterm birth
Diagnosis	Physical examination, fetal heart rate monitoring
Differential diagnosis	Cord presentation, vasa previa
Prevention	Avoiding artificial rupture of membranes in high-risk cases
Treatment	Emergency cesarean section, manual elevation of the presenting part
Medication	N/A
Prognosis	Depends on promptness of delivery
Frequency	0.1% to 0.6% of deliveries
Deaths	N/A

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.

See also

• Obstetrics
• Fetal distress
• Cesarean section