What is an Umbilical Cord Prolapse?

The umbilical cord provides important nutrients to the baby throughout a mother’s pregnancy as well as through labor and delivery. When a baby officially enters the world, a health care provider clamps off the umbilical cord and from that point forward, a baby begins to receive nutrients from a mother’s milk or formula.

Certain issues with the umbilical cord can injure a baby during pregnancy or during labor and delivery. One such issue is umbilical cord prolapse.

The umbilical cord prolapse is a circumstance in which the cord drops or prolapses. Generally, this occurs through the cervix and into the vagina, ahead of the baby. As a result, during delivery the cord may become trapped against the baby. Umbilical cord prolapse is a generally rare phenomenon, occurring only once in every 300 births.

As a flexible, tube-like structure, the umbilical cord is a lifeline to a baby. As such, a prolapse can decrease the number of nutrients that a baby receives and present a great danger to a developing child. When a baby presses against the umbilical cord during delivery, it can cause a lack of oxygen. Inadequate oxygen during delivery can lead to conditions including neurological damage, cerebral palsy, and even stillbirth.

Causes of Umbilical Cord Prolapse

Umbilical cord prolapse can occur in several ways, but the most common is premature rupture of the membranes (PROM). Some people may refer to this as "water breaking." When the compartments that contain the amniotic fluid that shelters a baby break too early, it puts the baby at increased risk. Other possible causes of umbilical cord prolapse include:

  • Delivery of a premature infant (before 37 weeks)
  • Multiple gestation (pregnancy with twins or triplets, etc.)
  • Too much amniotic fluid (polyhydramnios)
  • Breech positioning (when a baby emerges feet first from the birth canal)
  • An unusually long umbilical cord
Diagnosis of Umbilical Cord Prolapse

During the labor and delivery process, both mother and baby should be the subject of careful monitoring. A health care provider may attach monitors to a mother's baby to assess his or her heartbeat during delivery. Bradycardia – a fetal heart rate of fewer than 120 beats per minute – may be the first sign of an umbilical cord prolapse. A practitioner may also feel the umbilical cord during a cervical check as the delivery progresses.

How Should a Provider Treat Umbilical Cord Prolapse?

An umbilical cord prolapse could prove extremely dangerous to an infant. As such, it requires immediate intervention from a qualified health care provider. If a provider discovers a prolapsed cord, he or she may be able to move the baby away to help prevent oxygen loss. However, in some cases, the best option is immediate delivery via cesarean section.

If a health care provider recognizes and addresses an umbilical cord prolapse immediately, there will likely be no adverse effect to the baby. However, the longer the condition goes unrecognized, the greater the risk of negative outcomes such as brain damage or fetal death.

Preventing Umbilical Cord Prolapse

Unfortunately, there is not much a mother can do to prevent umbilical cord prolapse. However, appropriate prenatal care can help identify risk factors that may lead to an umbilical cord prolapse. Additionally, it's essential that a mother reports to labor and delivery as soon as her water breaks. This allows for continuous monitoring throughout the labor and delivery process and increases the likelihood of discovering the condition.

Umbilical cord prolapse is a serious complication of pregnancy that constitutes a medical emergency for an infant. Proper identification and immediate intervention are necessary to prevent oxygen loss and the possibility of brain damage or death.

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