What are the other Names for this Condition? (Also known as/Synonyms)

• Prolapse of Umbilical Cord

What is Umbilical Cord Prolapse? (Definition/Background Information)

• During delivery, if the umbilical cord appears at the cervical outlet before any part of the fetus, it is called Umbilical Cord Prolapse
• This condition is a medical emergency and requires immediate attention and care. Umbilical Cord Prolapse can occur in both vertex and breech position of the baby
• The placenta is an organ that connects the developing fetus to the uterine wall. It is a disc shaped reddish brown structure that connects the fetus to the mother through the umbilical cord
• The umbilical cord contains two umbilical arteries and one umbilical vein, providing a connection between maternal and fetal blood circulation
• The normal function of placenta is to supply nutrients and oxygen to the fetus from the mother’s blood and remove wastes from the fetal body
• The risk factors for Umbilical Cord Prolapse include preterm labor and delivery, and women who have had many pregnancies
• A long umbilical cord may also lead to an Umbilical Cord Prolapse. The condition is associated with severe fetal distress and abnormal fetal heart rate
• Depending on when the condition is discovered (either before or during delivery), an elective or emergency C-section delivery may be required. The prognosis of Umbilical Cord Prolapse is dependent upon several factors and is guarded
• Currently, it is not possible to prevent Umbilical Cord Prolapse. However, an early diagnosis of the condition can help to avoid the complications associated with it, to some extent

Who gets Umbilical Cord Prolapse? (Age and Sex Distribution)

• Umbilical Cord Prolapse may occur in pregnant women of all ages
• Women who are pregnant with both male and female fetuses can be affected
• There is no racial, ethnic, or geographical predilection observed

What are the Risk Factors for Umbilical Cord Prolapse? (Predisposing Factors)

The risk factors for Umbilical Cord Prolapse include:

• Preterm labor and delivery
• Obstetrics manipulation, such as amniotomy, can increase the risk. Amniotomy is the artificial rupture of membrane to deliberately induce labor
• Multiparous women (women with multiple births)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Umbilical Cord Prolapse? (Etiology)

• The exact cause of Umbilical Cord Prolapse is unknown
• Studies have indicated that the condition is linked to long umbilical cord, polyhydramnios (increased fluid in the gestational sac), and premature infants
• Research is currently being performed to identify the relevant causative factors

What are the Signs and Symptoms of Umbilical Cord Prolapse?

The signs and symptoms of Umbilical Cord Prolapse may include:

• Obstruction of blood flow causing reduced blood supply to the fetus
• Compression of umbilical cord
• Polyhydramnios
• Wrapping of the long cord around the fetal parts

How is Umbilical Cord Prolapse Diagnosed?

The diagnosis of Umbilical Cord prolapse may involve:

• Physical examination along with an evaluation of one’s medical history
• Prenatal ultrasound scan of the developing fetus may show abnormal position of the umbilical cord within the birth canal
• A careful examination of the placenta by a pathologist after birth of the child, to macroscopically (gross visual exam) and microscopically analyze the placental tissue may help establish a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Umbilical Cord Prolapse?

Complications due to Umbilical Cord Prolapse may include:

• Preterm labor and delivery
• Fetal distress (such as non-reassuring fetal heart rate)
• Umbilical cord compression can cause abnormal fetal heart rate
• Formation of true knots

How is Umbilical Cord Prolapse Treated?

The following strategies may be adopted towards the treatment of Umbilical Cord Prolapse in order to have an improved outcome:

• If a diagnosis of Umbilical Cord Prolapse is established prenatally, then an elective cesarean section (C-section) may be undertaken
• If the diagnosis is made during childbirth, then an emergency C-section is necessary
• Alternatively, an operative vaginal delivery may have to be performed, if the condition is diagnosed during childbirth. This procedure may be performed using techniques such as forceps delivery and delivery using vacuum extractor
• A careful and periodic monitoring of the pregnancy is necessary, since Umbilical Cord Prolapse is considered to be a high-risk pregnancy
• In case of a fetal distress, an immediate delivery of the baby should be considered

The healthcare provider may decide on the course of action on a case-by-case basis, analyzing all the health issues that are involved.

How can Umbilical Cord Prolapse be Prevented?

• Currently, there are definitive methods available to prevent Umbilical Cord Prolapse
• It is important to document the location of the umbilical cord during pregnancy. If the cord is in a location that increases the risk of a prolapse, then careful monitoring of the pregnancy is important

What is the Prognosis of Umbilical Cord Prolapse? (Outcomes/Resolutions)

• Umbilical Cord Prolapse is considered to be a medical emergency and the pregnancy is categorized as a high-risk one
• The prognosis of the condition is generally guarded, due to the high rate of complications that may develop

Additional and Relevant Useful Information for Umbilical Cord Prolapse:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/pregnancy-related-disorders/