Before or during birth, the umbilical cord can drop through your cervix into your vagina ahead of your baby. This complication, called umbilical cord prolapse, is a rare medical emergency. It can deprive your baby of oxygen and cause permanent brain damage. Immediate delivery is necessary.
Umbilical cord prolapse is a complication that occurs during labor, usually just before or during delivery. It happens when the umbilical cord drops (prolapses) out of its normal position and comes out of your cervix before your baby. In a typical delivery, your baby comes out first, followed by the umbilical cord. But, in a prolapse, the umbilical cord drops through your cervix and into your vagina before your baby does. When this happens, the umbilical cord can get squished between your baby’s body and your cervix or vagina.
A prolapsed umbilical cord is a medical emergency because it cuts off your baby’s blood and oxygen supply during delivery. Ideally, your baby drops down through your dilated cervix before the umbilical cord. When the umbilical cord comes first, it can get squished by your baby’s body. Each contraction of your uterus further squeezes the cord. When the cord is exposed to the air, the umbilical cord narrows, which also affects blood flow. Umbilical cord prolapse has the potential to cause severe and permanent disabilities.
Umbilical cord prolapse can be overt or occult (nonovert).
Prolapsed umbilical cords occur in about 1 in every 300 births. However, some studies say the rate is declining and may occur in 1 in 1,000 births.
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Your pregnancy care provider may suspect a cord compression issue if:
However, some cases of prolapse occur with no outward symptoms.
One study estimates that over half of prolapses occur within five minutes after the membranes rupture (your water breaks) and up to 70% occur within one hour of your water breaking.
There isn’t one specific thing that causes umbilical cord prolapse. Rather, there are several factors that increase your risk for prolapse.
Since most cases occur after your water breaks, healthcare providers know the flow of amniotic fluid can play a role. However, this isn’t the only cause.
The most common causes of umbilical cord prolapse are:
Umbilical cord prolapse can occur without any risk factors. However, certain conditions or factors may increase the chances of a prolapse occurring. In addition to the above causes, other risk factors include:
Umbilical cord prolapse is an uncommon but potentially fatal emergency. When this occurs during labor or delivery, the prolapsed cord becomes compressed which results in the fetus losing oxygen. Prompt treatment is necessary to avoid life-threatening outcomes. The complications of a prolapsed cord include:
Your healthcare provider typically diagnoses umbilical cord prolapse by:
Umbilical cord prolapse is an obstetric emergency that requires immediate delivery most of the time. The safest and quickest route of delivery is usually by C-section.
Your healthcare provider will attempt to relieve cord compression by moving you to a knee-to-chest position or manually lifting your baby away from the cord. This temporarily reduces the risk of oxygen loss. However, delivery must occur as soon as possible to prevent potential life-threatening outcomes.
If the problem with the prolapsed cord can be solved immediately, there may be no injuries. However, the longer the delay, the greater the chance of complications.
No, you can’t prevent umbilical cord prolapse. It’s also hard to detect during pregnancy because the umbilical cord and fetus move frequently. Your healthcare provider can only act quickly when umbilical cord prolapse occurs.
Yes, most babies survive a cord prolapse. The rate of mortality for infants with umbilical cord prolapse in a hospital setting is about 3%, although one study has the rate as high as 7%. The outlook for umbilical cord prolapse when it occurs outside the hospital is poor. The risk of infant death is nearly 20 times higher in these cases.
A note from Cleveland Clinic
Umbilical cord prolapse is an unpreventable and rare obstetric emergency that occurs during or just before delivery. Your healthcare team will work quickly to deliver your baby if they detect a prolapsed umbilical cord. There’s not much you can do to avoid one, but knowing the risk factors and what action needs to be taken may help you in the unlikely event it happens during childbirth.
Last reviewed by a Cleveland Clinic medical professional on 03/07/2023.
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