Definition

The umbilical cord links the baby to the placenta. This is an organ that nourishes the baby. Umbilical cord prolapse is when the cord passes through the birth canal in front of the baby's head. It happens after the membranes have ruptured.

As the baby is born, it puts pressure on the cord. This can lower or cut off blood flow and oxygen to the baby.

Umbilical Cord Prolapse
Prolapsed Umbilical cord

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Causes

This problem is caused by the cord coming out of the womb before the baby's head.

Risk Factors

Things may raise the risk are:

  • A mother with an odd pelvic structure
  • Breaking of the membranes
  • A placenta that is low
  • Having delivered five or more babies
  • Having a baby that is in the breech position
  • Being pregnant with more than one baby
  • Being born too early
  • Low birth weight
  • Having too much fluid in the womb
  • Birth abnormalities

Symptoms

The main sign is a change in the baby’s heart rate during birth. The cord may also be visible after a membrane rupture.

Diagnosis

This problem is diagnosed if the doctor sees or feels the cord before the baby is born.

The baby’s heartrate will be checked to make sure it is not too slow.

Treatment

This problem 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 birth—If the mother is ready, rapid birth with special tools may need to be done.
  • Birth by C-section—If the baby cannot be quickly delivered vaginally.

Cesarean Delivery
Cesarean Delivery

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Prevention

There are no known guidelines to prevent this problem.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

American Pregnancy Association
http://www.americanpregnancy.org

CANADIAN RESOURCES:

The Canadian Women's Health Network
http://www.cwhn.ca

The Society of Obstetricians and Gynaecologists of Canada (SOGC)
http://sogc.org

REFERENCES:

Royal College of Obstetricians and Gynaecologists (RCOG). Umbilical cord prolapse. Green-top Guideline No. 50. RCOG 2014.

Umbilical cord prolapse. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/umbilical-cord-prolapse. Accessed October 19, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Elliot M. Levine, MD, FACOG  Last Updated: 10/19/2020