What is a prolapsed cord?
A prolapsed cord occurs when the baby's umbilical cord falls into
the birth canal ahead of the baby's head or other parts of the
baby's body. Another name for this problem is cord prolapse.
A prolapsed cord is a serious emergency and can hurt the baby.
When the cord is compressed or squeezed (for example, between the
baby and the wall of the uterus or vagina), the baby may stop
getting blood and oxygen. The lack of oxygen (asphyxia) can cause
brain damage or death if the problem is not taken care of within
minutes.
How does it occur?
A cord prolapse does not happen often. It may happen when:
- There is too much amniotic fluid in the bag of waters (a
problem called polyhydramnios).
- The second baby of twins is being born.
- The baby is lying sideways in the uterus, not head or bottom
down (called a transverse lie).
- The baby is in breech position (head up in the uterus).
- The bag of waters breaks before the baby moves down into the
pelvis.
- A baby is born early (prematurely).
What are the symptoms?
You cannot feel if the baby's cord is prolapsed. The problem may
be found when the fetal heart monitor, which is usually attached
to your abdomen, shows that the baby's heart rate is slower or
abnormal.
How is it diagnosed?
Your healthcare provider will feel in the vagina for the umbilical
cord.
What is the treatment?
The treatment depends on the situation:
- If the cord is still pulsating (beating) and can be seen or
felt in the vagina, your healthcare provider will hold up the
part of the baby that is coming out first. This takes pressure
off the cord. Sometimes you will be asked to get up on your
knees and bend over. Your provider will keep a hand in your
vagina until the baby is delivered the fastest way possible,
usually by emergency C-section. You will be given oxygen to
help the baby get more oxygen.
- If the cord is felt through an amniotic sac that has not
broken, your provider will try not to break the bag of waters.
You will be asked to get into a position that takes pressure
off the cord, either on your hands and knees or with your hips
raised. If the prolapsed cord causes the baby's heartbeat to
slow, a C-section will probably be necessary.
- If the baby is positioned head down and low in the birth canal
and your cervix is fully dilated, your provider may try to get
the baby out quickly with forceps or vacuum extraction. If you
are not fully dilated, a C-section will be done as quickly as
possible.
- If the baby is breech, a vaginal delivery may be possible if
you are fully dilated, the baby's bottom is about to be
delivered, and you have delivered a baby before. Otherwise,
the baby may need to be delivered with a C-section.
How long will the effects last?
If the problem with the prolapsed cord can be solved right away,
there may be no permanent injury. The longer the delay, the
greater the chance of permanent brain damage or death for the baby
if the cord is compressed and the baby is deprived of oxygen.
How can I take care of myself?
You should try to remain calm and follow your healthcare
provider's directions.
If you are concerned about this or any other problem with
delivery, discuss your concerns and questions with your provider
before you go into labor. This will help you deal with a problem
delivery in the safest and calmest way possible.
Developed by Phyllis G. Cooper, RN, MN, and RelayHealth.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.