Definition

The umbilical cord is a wrapped bundle of blood vessels. It joins a fetus to the mother's placenta. The placenta is an organ that supplies blood and oxygen to the fetus throughout the pregnancy.

Umbilical cord prolapse is problem that can happen during labor. The cord becomes trapped in the birth canal, in front of the baby's head. The pressure on the cord can slow or stop the flow of blood and oxygen to the baby.

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Causes

Umbilical cord prolapse will most often happen after water has broken. The prolapse is simply caused by the position of the cord.

Risk Factors

Things may raise the risk include:

• Narrow pelvis
• Artificially rupture of membranes to help labor move along
• A placenta that is attached low in the uterus
• Having delivered five or more babies in the past
• Having a baby that is in the breech position
• Being pregnant with more than one baby
• Delivery before 37 weeks
• Baby with low birth weight
• Having too much amniotic fluid
• Birth abnormalities

Symptoms

An umbilical prolapse will cause a change in the baby’s heart rate during labor. The cord may also be visible after water has broken.

Diagnosis

A prolapse is diagnosed if the cord is seen or felt in the birth canal. It may be checked if there is a concern with the baby's heart rate.

Treatment

Umbilical cord prolapse is an emergency. It is treated by:

• Taking pressure off the cord—The doctor may be able to move the baby away from the cord. The mother may also be asked to move her body to ease pressure from the cord and protect the baby.
• Rapid vaginal delivery—If the mother is fully dilated at the time. Special tools may be used to help the delivery.
• Emergency C-section—If the baby cannot be quickly or safely delivered vaginally.

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Prevention

There are no known guidelines to prevent this problem.