The umbilical cord is a flexible, tube-like structure that, during pregnancy, connects the fetus to the mother. The umbilical cord is the baby's lifeline to the mother. It transports nutrients to the baby and also carries away the baby's waste products. It is made up of three blood vessels – two arteries and one vein.
Umbilical cord prolapse is a complication that occurs prior to or during delivery of the baby. In a prolapse, the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. The cord can then become trapped against the baby's body during delivery. Umbilical cord prolapse occurs in approximately one in every 300 births.
The most common cause of an umbilical cord prolapse is a premature rupture of the membranes that contain the amniotic fluid. Other causes include:
An umbilical cord prolapse presents a great danger to the fetus. During the delivery, the fetus can put stress on the cord. This can result in a loss of oxygen to the fetus, and may even result in a stillbirth.
The doctor can diagnose a prolapsed umbilical cord in several ways. During delivery, the doctor will use a fetal heart monitor to measure the baby's heart rate. If the umbilical cord has prolapsed, the baby may have bradycardia (a heart rate of less than 120 beats per minute). The doctor can also conduct a pelvic examination and may see the prolapsed cord, or palpate (feel) the cord with his or her fingers.
Because of the risk of lack of oxygen to the fetus, an umbilical cord prolapse must be dealt with immediately. If the doctor finds a prolapsed cord, he or she can move the fetus away from the cord in order to reduce the risk of oxygen loss.
In some cases, the baby will have to be delivered immediately by cesarean section. If the problem with the prolapsed cord can be solved immediately, there may be no permanent injury. However, the longer the delay, the greater the chance of problems (such as brain damage or death) for the baby.
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