
21/07/2025
CAUSES UMBILICAL CORD PROLAPSE.
Umbilical cord prolapse is a serious obstetrical emergency where the umbilical cord slips down in front of the baby after the water breaks, potentially leading to fetal hypoxia and de@th.
It occurs when the cord descends through the cervix and alongside or below the presenting part of the fetus, often during labor or when the membranes rupture prematurely. Prompt diagnosis and delivery, usually by Cesarean section, are crucial to minimize fetal risks.
What is Umbilical Cord Prolapse?
Umbilical cord prolapse happens when the umbilical cord descends through the cervix before the baby's head or presenting part during labor.
The cord can be felt or seen by a healthcare provider.
It's a medical emergency because the cord can be compressed between the baby and the mother's pelvis, cutting off the baby's bl@ and oxygen supply.
This compression can lead to fetal hypoxia (lack of oxygen), bradycardia (slow heart rate), and potentially fetal death or permanent disability.
The risk of fetal mortality is high if not promptly addressed.
Risk Factors:
1: Premature rupture of membranes (water breaking before labor).
Fetal malpresentation (breech or other non-cephalic presentations).
2: Premature BIRTH.
3: Low birth weight.
4: Polyhydramnios (excess amniotic fluid).
5: Multiple gestation (twins or more).
6: Long umbilical cord.
7: Previous uterine surgery.
SYMPTOMS:
1: Sudden and severe drop in fetal heart rate: (fetal bradycardia or decelerations).
2: Visible or palpable umbilical cord: in the va**na.
MANAGEMENT:
Immediate Cesarean section: is usually required.
WHILE awaiting delivery:
Elevate the fetal presenting part off the cord to relieve pressure.
MATERNAL POSITION: knee-chest or Trendelenburg (head down, feet up).
Tocolytics (medications to stop contractions) may be considered if there are persistent fetal heart rate abnormalities and delays in delivery.
Digital elevation of the fetal head: by the healthcare provider.
Filling the bladder with saline: to elevate the presenting part.
Continuous monitoring of fetal heart rate .
Prevention:
While not always preventable, awareness of risk factors and prompt management of ruptured membranes can help.
Simulation training for healthcare providers can improve their response to this emergency.