Definition

Umbilical cord prolapse is a condition during the last stages of pregnancy in which the umbilical cord descends into
the vagina prematurely. This most often occurs after the membranes have ruptured and the baby moves into the birth
canal for delivery.

As the baby passes through the vagina during delivery, it puts pressure on the cord, which can decrease or cut off the
infant’s blood supply.

Umbilical cord prolapse is a very dangerous condition that can cause stillbirth unless the baby is delivered quickly,
usually by cesarean section (C-section). Other complications include infant brain damage from lack of oxygen.
Most babies delivered quickly through cesarean section do not suffer from complications caused by this condition.

Umbilical cord prolapse is relatively common, occurring in one in every 300 births.

Umbilical Cord Prolapse

Causes
The most common cause of umbilical cord prolapse is the premature rupture of the membranes containing the
amniotic fluid. Other common causes include:

    
 Premature delivery
 Multiple births (eg, twins, triplets)
 Excessive amounts of amniotic fluid (polyhydramnios)
 Breech delivery (feet first)
 Abnormally long umbilical cord

Risk Factors
These risk factors increase your chance of developing umbilical cord prolapse. Tell your doctor if you have any of
these risk factors:

    
 Having a baby that is in the breech position
 Premature rupturing of the membranes
 Having multiple births in one pregnancy—The second baby delivered is at greater risk.
 Having an unusually long umbilical cord
 Having too much amniotic fluid in the membranes around the fetus
Symptoms
The symptoms of umbilical cord prolapse include seeing or feeling the umbilical cord in the vagina prior to the baby's
delivery. Low heart rate of less than 120 beats per minute is also a symptom that the baby is in distress from
umbilical cord prolapse.

Diagnosis
Your doctor will ask about your symptoms and medical history, and do a physical and pelvic exam.

Tests may include the following:

    
 Heart rate monitoring of the mother and baby
 Pelvic examination to see and feel the umbilical cord present in the vagina

Treatment
Treatment options include:

    
 Having a C-section—If the baby cannot be quickly delivered without risk of insufficient oxygen, then the
baby will be delivered by C-section.
 Removing pressure from the cord—In some cases, the doctor may be able to move the baby away from the
cord so as not to disrupt oxygen supply to the baby. The mother may also be asked to move into a position that
removes pressure from the cord and protects the baby.
 Rapid delivery—If the mother is ready to deliver, the doctor may try to deliver the baby very quickly using
forceps or a vacuum extractor.

Cesarean Delivery

Prevention
Umbilical cord prolapse is difficult to prevent. But, if you have risk factors, talk to your doctor about C-section and
other ways to help prevent the risk of umbilical cord prolapse.