“The stork dropped it”! “We got you from the hospital”! — sounds familiar, right??
These were the amusing answers our mothers gave each time we asked how we were born. On a serious note, childbirth is quite unpredictable and prone to several known, and rare, complications. So much so that most moms are simply relieved they managed it. One such pregnancy-related complication, albeit rare, is Umbilical Cord Prolapse!
So, what exactly is this condition? How does it affect the baby and delivery? Let’s understand this together and its implications. Why, you ask? Although this condition is rare, it is always better to be prepared for any unexpected situations during delivery. So that when the need arises, you’re ready to take immediate decisions when the time is of essence.
Umbilical Cord Prolapse: Definition
During pregnancy, the umbilical cord helps in carrying blood that’s rich in oxygen and nutrition, to the growing baby. This flexible structure is coiled and remains attached to your baby’s belly button at the time of delivery. Once the baby comes out, it is followed by the umbilical cord which is then clamped and cut without causing any pain to the baby.
At the time of delivery, the baby drops down into your dilated cervix, gets pushed through the birth canal and comes out of the vagina. Throughout this pathway, the baby stays ahead of the umbilical cord. However, when the umbilical cord drops into the cervix first, ahead of your baby, that’s when it is called an umbilical cord prolapse (drop).
What Happens When The Umbilical Cord Prolapses
Here’s what happens when the umbilical cord drops first before the baby:
- It gets squeezed between your baby’s body and cervix or vagina
- The compression cuts off oxygen from the cord to the baby
- As labour contractions progress, the cord’s compression worsens
- As the cord gets exposed to air, it becomes narrow, thus affecting the blood flow too!
All this can prove fatal to the baby.
Umbilical cord prolapse is largely categorised into 2 types :
- Overt Prolapse: The cord comes down the cervix & vagina before the baby
- Occult Prolapse: The cord comes down along with the baby, and not before or after.
Umbilical Cord Prolapse- Symptoms & Causes
Umbilical cord prolapse can be detected by your doctor before delivery.
Here are a few symptoms that typically suggest an umbilical cord prolapse:
- The doctor is able to feel or see the cord after your water breaks
- The foetal heart rate suddenly changes, slows down, or drastically drops
However, in many cases, the prolapse occurs within minutes to 1 hour of your water breaking.
Causes Of Umbilical Cord Prolapse
This condition is caused by just one factor, but a number of other factors. But, since it predominantly occurs after a water break, your doctor’s knowledge of the amniotic fluid flow plays a crucial role.
That being said, the other most common causes of umbilical cord prolapse are:
- Multiple pregnancies (twins, triplets, more)
- Breech presentation of the foetus, where the head is not towards the cervix
- Excessive amniotic fluid (Polyhydramnios)
- Premature water breaking (membrane rupture) before full term gestation
Umbilical Cord Prolapse — Diagnosis & Treatment
As discussed earlier, umbilical cord prolapse usually occurs within minutes to an hour after your water break. Still, your doctor will be able to diagnose it :
- During a vaginal exam
- By looking out for abnormal foetal heart rate
- When there’s a sudden change in your blood pressure
Treatment of Umbilical Cord Prolapse
This condition occurs at such a short notice that it requires immediate action. The fastest, and most effective option is emergency c-section.
At times, delivery doctors may try to relieve this condition by changing your position to knee-to-chest or by manually moving the baby away from the cord. However, this is a temporary method. Since the baby and cord move continuously due to labour contractions, a c-section is the best option to avoid foetal mortality.
Umbilical Cord Prolapse- The Final Say!
The delivery of a baby can be quite unpredictable — for both mother and medical professionals. While many deliveries can be seamless, barring the labour pain, there may be times when emergency situations arise, warranting quick decision making. And umbilical cord prolapse is one such medical emergency that can potentially be fatal to the baby. As stressful as it may sound, the fact is that the majority of babies do survive an umbilical cord prolapse, in a hospital setting.
Another factor to remember is that it is a rare condition. And most well-trained obstetricians are prepared for such emergencies. While there’s pretty much nothing to worry about, knowing about this condition and why your doctor may be taking an emergency call during delivery will help save time, and your baby’s life!
Frequently Asked Questions
1) What is the best position for cord prolapse?
The ideal position for umbilical cord prolapse would be knee-chest position with the expectant mom facing downwards.
2) What is the nursing management of cord prolapse?
The traditional nursing management method is ensuring a knee-chest delivery position while also manually trying to lift the baby’s presenting part with fingers.
Article Source :
This Article was originally published on :
https://www.lifecell.in/blog/health-bank/umbilical-cord-prolapse