Umbilical cord prolapse is a very rare obstetric emergency in which the umbilical cord moves into the birth canal ahead of the baby after the rupture of the amniotic sac. This condition occurs in less than one percent of pregnancies, and when it is caught and addressed rapidly, the risk of complications associated with umbilical cord prolapse is as low as 12%.
Certain things can increase the risk of developing a prolapsed umbilical cord, including premature labor, breech births, multiple births, and excessive amniotic fluid. Since many of these situations are also considered factors which can put a pregnancy into the high risk category, women at risk of umbilical cord prolapse are already monitored very carefully during labor and delivery, making it easier to catch this condition before it becomes a serious problem.
In overt umbilical cord prolapse, the umbilical cord precedes the baby, and may even emerge into the vagina ahead of the baby. Occult prolapse occurs when the umbilical cord moves so that it is next to the baby. The issue with both cases is that the baby will put pressure on the displaced cord during labor, and the pressure could off the baby's supply of oxygenation and nutrients, creating the potential for complications such as brain damage or death.
If umbilical cord prolapse presents, there are several options which can be pursued. Some obstetricians will attempt to allow the woman to deliver vaginally, monitoring the baby for any signs of distress and manually repositioning the cord if possible. If the doctor feels that this is not safe, a cesarean section may be recommended to remove the baby before he or she goes into distress. While the woman is prepared for surgery, she will be placed in a head down position to reduce pressure on the cord, and a member of the medical team may also reposition the baby to relieve pressure.
There is nothing which can be done to prevent umbilical cord prolapse, and sometimes it happens in entirely healthy and low-risk pregnancies in which no one would have predicted it. Monitoring mother and baby during labor can identify the early signs of umbilical cord prolapse and other symptoms of distress or problems with the delivery. Women with high risk pregnancies may want to talk with their obstetricians about the potential complications which could appear during labor, and how they want to respond; for example, if complications do emerge, a woman may prefer a cesarean rather than an attempt to deliver vaginally to avoid endangering the baby.
