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What is an umbilical cord prolapse?

Normally, the baby is birthed from the vagina first, with the cord and placenta following it. In some cases, however, the cord drops down into the cervix before the baby has emerged. This is an umbilical cord prolapse and is considered an obstetrical emergency because the pressure put on the cord from the baby can restrict the supply of blood and oxygen to the baby – delivery must occur immediately.



What should I do if I am at home or at work?

  • Call your health professional an umbilical cord prolapse is a very dangerous condititon.
  • Never push back the umbilical cord yourself.
  • Always wait for a health professional to arrive.TThe mother should be helped into one of the following positions to relieve cord compression. The side-down position is the more appropriate position for transfer by ambulance.Knee Chest Position
Knee chest position

Knee-chest position uses gravity to shift the futs out of the pelvis. The woman’s thighs should be at right angles to the bed and her chest flat on the bed.

Side down position

The woman’s hips are elevated with two pillows, gravity relieves pressure on the umbilical cord when woman hips are elevated as high as possible.

 

Causes and symptoms of umbilical cord prolapse

The most commen symptom of a prolapsed umbilical cord is seeing or feeling the cord before the baby is delivered. There are several causes of umbilical cord prolapse:

  • Premature rupture of the membranes. This is the most common cause. If a physician ruptures the membranes  too early, the baby’s head is too high up in the uterus. The fluid loss and unengaged position of the baby’s head in the cervix allows the umbilical cord to precede the baby. The cord can then become compressed as the baby descends.
  • Premature delivery
  • Delivery of twins. Ther first baby may push out the cord of another baby upon exiting the mother.

 

  • Abnormally long cord
  • Excessive amniotic fluid. When there is a large volume of fluid, the cord can be forced out before the baby due to the pressure of the fluid exiting the mother.
  • Unusual delivery presentation. This would include a breech position where the baby comes through the birth canal feet first allowing space for the cord to slip through before the feet.

 

Birth attendant taking care of an umbilical cord prolapse and of a nuchal cord prolapse

If a vaginal birth is not possible very quickly, you will be advised to have an immediate caesarean delivery.

Taking care of an umbilical cord prolapse

Before the fetus has come down a loop of cord comes out first. The health professional can push the cord back inside behind the babies head so the babies head can come down preventing the cord to come down first.

Taking care of a nuchal cord prolapse

When the baby is already starting to deliver and the head is comming down you notice the umbilical cord wrapped around the babies neck. The health professional can grab the cord and reduce it around the babies neck and then deliver the rest of the infant.

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