Umbilical cord prolapse and compression are some of the serious yet uncommon complications seen during the birth of a child. Interrupted oxygen flow during these events can pose risks to the baby and require immediate medical intervention. Thus, expectant parents and caregivers need to understand these conditions, their consequences, and management options.
What is Umbilical Cord Prolapse?
While most babies are born with intact umbilical cord, prolapse occurs when the cord slips into the cervix or vagina before the baby is born. This can cause the umbilical cord clamping in the baby’s birth canal, cutting off the oxygen and blood flow and causing serious complications, including hypoxia, brain damage, or even stillbirth — rarely. Umbilical cord prolapse is a medical emergency and must be treated as such, as it can be a life-threatening condition requiring a cesarean delivery to save the baby’s life.
There are two main types of prolapse –
1. Overt Prolapse
The umbilical cord visibly slides through the cervix and positions ahead of the baby. It is easily detected on vaginal examination and usually requires immediate action.
2. Occult Prolapse
This form appears less since the cord is not outward visibly and may be compressed inwardly. An occult prolapse can be diagnosed only by monitoring, and it also needs prompt delivery when distress is noted.
3. Funic Prolapse
Here, the umbilical cord falls into the birth canal before the amniotic sac ruptures. Since the membrane is intact, the umbilical cord is protected, but it can quickly become an overt prolapse.
What Causes Umbilical Cord Prolapse?
Several factors can increase the likelihood of umbilical cord prolapse -
1. Breech Presentation:
If the baby’s feet or bottom are turned (breech), this raises the chance that the umbilical cord can pass the baby down into the birth canal.
2. PROM (Premature Rupture of Membranes):
The risk of cord movement into the cervix is higher if the amniotic sac has broken before labor starts while the baby’s head is not fully engaged.
3. Long or Thin Umbilical Cord:
The umbilical cord is more likely to shift downwards if it is unusually long or thin, particularly if there is too much space around the baby.
4. Water Breaking (Amniotic Fluid Release):
The rush of fluid when the water breaks can push the cord into the cervix enough to cause prolapse.
Management and Prevention
Immediate delivery is the primary approach if umbilical cord prolapse occurs. Sometimes, a C-section is necessary, but repositioning the mother to relieve pressure on the cord may also help temporarily. In mild cases, increasing the mother’s oxygen intake can increase blood flow through the umbilical cord. A C-section may be necessary if the baby does not show signs of distress, though only in severe cases.
Understanding Umbilical Cord Compression
Umbilical cord compression is different from prolapse. About 1 in 10 births is accompanied by compression. Most compressions are mild and will resolve themselves, however, prolonged or severe compression could restrict blood and oxygen flow to the fetus, and could potentially have health implications.
Umbilical cord compression can cause changes in the baby’s heart rate and variable decelerations. If detected, health providers may use monitoring to assess the baby’s health closely. Amnioinfusion—injecting a sterile saline solution into the uterus—in some cases relieves the pressure on the umbilical cord and restores good blood flow.
Final Thoughts
Umbilical cord prolapse and compression are rare, but awareness of these complications can help parents prepare for the unexpected. Fetal distress due to these conditions is best monitored during labor by a trained medical team, and rapid action is needed to protect the health of both the baby and the mother.
Umbilical cord benefits go above and are the new field of scope and development for future medical treatments. In addition, Cryoviva helps parents with umbilical cord preservation of their babies, which may grant future health benefits to their children and the family.
