UMBILICAL CORD PROLAPSE
Umbilical Cord Prolapse is a dangerous childbirth complication that occurs during delivery.
Let’s first discuss, what is umbilical cord?
The umbilical cord is the literal lifeline between the mother and the baby. Until the moment of birth when the baby takes his first breath the umbilical cord works as the lungs of the baby. It provides the oxygen and nutrients to the fetus and carries out the waste material.
If the blood supply of the umbilical cord is cut due to any reasons, it can result in brain damage in a matter of minutes.
What is Umbilical Cord Prolapse?
In normal child birth, the umbilical cord is positioned behind the baby as it descends the birth canal.
Umbilical proplapse occurs when the cord drops down into the birth canal ahead of the baby, instead of behind the baby.
This can be very dangerous because when umbilical cord comes out first, the head or body of the baby comes through and compress the umbilical cord that severely restricts the oxygen supply to the baby.
In this case, the baby’s head is not engaged in pelvis, if the mom has a rupture of membrane, it leaves an opportunity for the umbilical cord to fall through and deliver before the head. Once that happens, any part of the baby that comes out first, start to occlude the umbilical cord and cut off the oxygen source to the baby by squeezing and compressing the umbilical cord, eventually leading to hypoxia. This situation is the time of critical emergency.
Incidence of Umbilical cord prolapsed is 0.1-0.6% of all births
It carries a perinatal mortality rate of 91/1000.
When does Umbilical Cord Prolapse occur?
Umbilical cord prolaspe may occur at any time, during the delivery or before the birth.
It occurs spontaneously and without warning.
Let’s talk about the risk factors
- Fetal malpresentation : High presentation, breech presentation, unstable lie, oblique or transverse lie
- Polyhydramnios – lot of fluid creates space
- Artificial rupture of membranes
- Small or tiny fetus
- Low birth weight (less than 2500g)
- Multifetal gestation or multiparity
How can Umbilical Cord prolapsed be prevented?
It cannot be prevented by the doctors but can only be managed. The key to treating it is to be ready ahead of the problem before it does any potential harm to the baby’s life.
- Assess the fetal monitoring data to keep check on the heart rate of the baby.
- Emergency c-section is usually the appropriate to respond to umbilical cord prolapsed.
What can we do to minimize the effects to both the fetus and the mother?
Early diagnosis and prevention is the best way to minimize the umbilical cord prolapsed. Your doctor can do following assessment findings to prevent and manage the cord prolapsed:
- Palpation
- Ultrasonography
- Variable and prolonged decelerations
- Suspecting prolapsed when there is sudden change in fetal heart
What are the complications of umbilical cord prolapse?
If it is not promptly diagnosed and not immediately delivered by c-section, it can lead to fatal consequences.
- Cerebral palsy
- Neurologic birth injuries`
- Still birth