12345 Umbilical Cord Prolapse

Overview

Umbilical cord prolapse is a rare but serious condition that can happen during labor. The umbilical cord, which carries oxygen and nutrients from the placenta to the baby, slips down through the opening of the cervix and into the birth canal before the baby is born. This can press on the cord and reduce the baby’s oxygen supply. It is a medical emergency that needs immediate care.

No, it is uncommon. It happens in about 1 to 2 pregnancies out of every 1,000.

It affects pregnant women during labor, especially if the baby is breech (feet or bottom first), if there is extra amniotic fluid, if the mother is carrying twins or triplets, or if the baby is preterm.

Symptoms

Common symptoms

• Feeling the umbilical cord in the vagina
• Seeing the cord sticking out of the vagina
• Sudden severe back pain or pelvic pressure
• A feeling that something is coming through the birth canal
• A slow or irregular baby heart rate, detected during labor monitoring

Symptoms in children

• Not applicable — this condition occurs only during childbirth, not in children.

Symptoms in older adults

• Not applicable — this condition occurs only during childbirth, not in older adults.

Causes

Main causes

• The umbilical cord slips down past the baby and into the birth canal after the membranes (waters) break
• This can happen when the baby is small, premature, or positioned feet-first (breech)
• Extra amniotic fluid or a long umbilical cord can also make it more likely

Risk factors

• Breech baby (feet or bottom first)
• Twins or triplets
• Too much amniotic fluid (hydramnios)
• Premature delivery
• Artificial rupture of the membranes, where a doctor breaks the waters during labor
• A long umbilical cord

When to see a doctor

See a doctor urgently if:

• If you feel or see the cord after your waters break, call your local emergency number immediately.
• If you have sudden severe back pain or pelvic pressure during labor, tell your midwife or doctor right away.
• If your baby’s heart rate slows or shows signs of distress, get urgent medical help.

Book a routine appointment if:

• There is no routine reason to wait with this condition — it is always an emergency.

Diagnosis

A doctor or midwife diagnoses it during labor, usually after noticing an abnormal baby heart rate and then performing a vaginal examination to feel for the cord.

Tests that may be done

• Vaginal examination to feel for a loop of cord
• Continuous fetal heart rate monitoring to check the baby’s wellbeing

What to expect at your appointment

If a cord prolapse is detected, the hospital team will act quickly. You may be asked to change position to ease pressure on the cord, and you will be prepared for an emergency birth. Staff will explain each step as they go.

Treatment

Umbilical cord prolapse requires immediate delivery of the baby to restore blood flow and oxygen. The mother may be positioned to lift the baby off the cord, and the medical team will work to deliver the baby as safely and quickly as possible.

Self-care at home

• If you suspect a cord prolapse at home, call your local emergency number immediately — do not wait.
• While waiting for help, get on your hands and knees with your bottom raised high, or lie on your side with your hips propped up on pillows. This helps take pressure off the cord.

Medical treatments

The baby is usually delivered by caesarean section (surgery) or, if labour is very advanced, by an assisted vaginal birth using a suction cup or forceps. While preparing for birth, the doctor or midwife may hold the cord inside the vagina or fill the bladder with fluid to lift the baby off the cord. These steps help protect the baby until delivery.

When is surgery considered?

A caesarean section (C-section) is often the safest and quickest way to deliver the baby during a cord prolapse.

Living with this condition

After a birth complicated by cord prolapse, it is normal to feel shaken. Give yourself time to recover physically and emotionally. If you had a C-section, follow your doctor’s advice on wound care. Attend your postnatal checkups so your healing and wellbeing can be monitored.

Lifestyle tips

• Rest when you can and accept help from family and friends.
• Keep your postnatal appointments.
• Talk to your partner or a trusted friend about your birth experience if you need to.

Diet and exercise

Eat a balanced, nutritious diet to help your body recover. Gentle activity, like short walks, can begin once your health care provider says it is safe. Avoid heavy lifting and strenuous exercise until you get the all-clear.

Mental health and emotional wellbeing

A cord prolapse can be frightening. You may feel anxious, upset, or find yourself replaying the event. This is a common response to a traumatic birth. If these feelings last longer than a couple of weeks or affect your daily life, speak to a health care provider.

Prevention

In most cases, umbilical cord prolapse cannot be predicted or prevented. However, if you have known risk factors, your healthcare team will plan for your baby to be born in a hospital with immediate access to emergency surgery, so that any problem can be handled quickly.

Screening programmes

During pregnancy, routine ultrasounds can show if the baby is breech or if there is extra amniotic fluid, which may signal a higher risk. Your care team will take this into account when planning your delivery.

Complications

If left untreated

• Compression of the cord can reduce the baby’s oxygen supply.
• This can lead to brain damage due to lack of oxygen.
• In severe cases, it can be life-threatening for the baby.

Long-term outlook

With prompt emergency care, the outcome for most babies is very good. Quick delivery and close monitoring greatly reduce the risks. The vast majority of babies born after a cord prolapse in a hospital with emergency facilities go on to be completely healthy.

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