Prolapsed Cord

The concern of an expecting mother doesn't end, until and unless she gives birth to a healthy baby. Indeed, pregnancy and childbirth are some of the most crucial phases in a woman's life. After becoming pregnant, nothing can be more important than a safe delivery for every woman. While many are lucky to have a problem-free childbirth, some experience obstetric complications of which prolapsed cord is one of them. It poses great danger for the baby, which at times, causes death.

What is Prolapsed Cord?

In order to understand what a prolapsed cord is, you can visualize the normal consequences in natural childbirth. As we all know, the umbilical cord is a tube like, flexible part that connects the developing fetus to the mother for nutrition. In rare instances, the cord drops or falls into the open cervix, and reaches the vaginal opening before and during child delivery. Such a condition is referred to as cord prolapse. Eventually the fallen cord may get entangled against the baby's body, thus increasing pressure in the cord and disturbing a smooth delivery.

Causes and Symptoms

The main reason for umbilical cord prolapse is premature tear of the membrane, which holds the amniotic fluid (amniotic sac). Other probable causes are an abnormal presentation of the fetus, abnormally long cord, excess amniotic fluid, premature baby delivery and multiple pregnancy. The risk factors for cord prolapse are abnormal placentation, low weight at birth, pelvic tumors and multiparity.

Coming to prolapsed cord signs and symptoms, the fallen cord protrudes in the vaginal opening and can be seen during vaginal examination. While examining with a fetal heart monitor, a fetus with prolapsed umbilical cord problem usually has a decreased heart rate (less than 120 heartbeats per minute) or bradycardia. However, the most concerning issue with this medical emergency is that it may occur without any physical symptoms. In some, the fetal heartbeat is normal. Thus, timely diagnosis of prolapsed cord is difficult in some cases.

Diagnosis and Treatment

In case of suspected cord prolapse, the doctor may feel or palpate the pelvic area with his/her fingers to detect the fallen cord. The heart rate of the fetus is monitored for any changes. To be more precise, the doctor examines both the mother and the fetus for prolapsed cord symptoms. After confirmation of cord prolapse, therapeutic intervention involves lowering the pressure in the umbilical cord and delivering vaginally as soon as possible to avoid loss of oxygen. Nevertheless, practical implementation of both the approaches is not successful in most cases.

The last resort for prolapsed cord treatment is delivering the fetus with an emergency c-section (cesarean section). During the entire procedure, the pregnant woman is allowed to remain in Trendelenburg position, i.e., feet orienting in a higher level than the head. The objective is to move away the intestinal portion from the pelvic area by force of gravity. Overall, this reduces pressure to the cord and aids in getting easy access to the pelvic organs. With recent prolapsed cord nursing intervention, the mortality rate of fetus has been decreased significantly.

In the new treatment method, 500 ml fluid is delivered in the woman's bladder via a catheter. The fluid serves dual purposes in saving the life of the fetus. Firstly, it reduces compression in the cord and secondly, it causes the presenting part of the fetus to move upward for safe delivery. If therapeutic intervention doesn't work in removing the pressure from the cord, the consequences are cutting oxygen supply to the baby, resulting in brain damage and stillbirth.

Regarding prolapsed cord statistics, it is a rare incidence with an occurrence rate of less than 1 percent. According to medical data, this complication is observed in one out of every 300 childbirth cases. And the fetus mortality rate is recorded to be 11-17 percent. Successful delivery within a short time is the prime objective for dealing with a cord prolapse.