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Cord prolapse—your questions answered

What is cord prolapse?

The umbilical cord connects your baby to the placenta, providing vital nutrients and oxygen-rich blood. An umbilical cord prolapse occurs when the umbilical cord slips down in front of the baby after the waters have broken. A loop of cord can come through the open cervix into the vagina.

Why is it an emergency?

When the umbilical cord prolapses, it can become pressed against the baby’s body and the amount of oxygen-rich blood passing through to the baby is reduced, resulting in an insufficient oxygen supply to the baby. If an umbilical cord prolapse is diagnosed the baby will need to be delivered urgently to avoid potential harm related to the reduced oxygen supply.

How common is cord prolapse?

Umbilical cord prolapse is uncommon, occurring in between 1 in 200 and 1 in 1000 births.
If the baby is presenting head first and engaged in the pelvis at term then cord prolapse would be considered unlikely, provided there were no other risk factors identified.

Can cord prolapse be anticipated?

It is not possible to predict a cord prolapse. There is also no benefit in performing ultrasound scans to determine the position of the umbilical cord as the position changes throughout pregnancy and labour.

Can cord prolapse be prevented?

Certain groups of women are at increased risk of cord prolapse and for this reason recommendations may be made regarding admission to hospital, induction of labour or artificial rupture of membranes in a controlled environment in the hospital. This ensures quick access to an operating theatre should a cord prolapse develop.

Examples of increased risk of cord prolapse include:

  • If the baby is not presenting head first close to term (e.g. breech or transverse)
  • If the waters break or labour starts pre-term
  • A multiple pregnancy (twins or triplets)
  • If there is increased fluid around baby—this condition is called polyhydramnios and is usually detected on an ultrasound scan during pregnancy
  • A small baby
  • A low-lying placenta
  • If the baby’s head is not engaged in the pelvis prior to artificially breaking waters— sometimes referred to as a ‘high head’.

How is a cord prolapse diagnosed?

A prolapsed cord can be detected on examination by your midwife or doctor, where they may feel the cord in the vagina. A cord prolapse may also be diagnosed when there is a change in baby’s heart rate pattern or other signs of distress on the fetal heart monitor. An examination will assist your midwife or doctor to diagnose the cord prolapse and plan the safest way to deliver your baby.

What could cord prolapse mean for a mother and her baby?

If a cord prolapse is detected, urgent delivery of the baby is required; this may be by vaginal birth or emergency caesarean section depending on the individual circumstances. A general anaesthetic may also be required so an emergency caesarean section can be performed as soon as possible.

A neonatal/paediatric doctor and midwife will also be present to look after the baby after birth. The baby may require closer observation or treatment in the Neonatal Critical Care Unit. It is rare for a baby to die following a cord prolapse.

What about next time?

The chance of having a cord prolapse in a subsequent pregnancy would be unlikely. Your doctor may recommend delivery options depending on individual factors.

If you have any further questions, please speak to your doctor before going home.

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430202
Last modified 27/8/2018.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 08/1/2018
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