Umbilical cord prolapse

Umbilical cord prolapse
Classification and external resources

Cord prolapse, depicted by W.Smellie, 1792
ICD-10 O69.0, P02.4
ICD-9 663.0, 762.4
DiseasesDB 13522
eMedicine med/3276

Umbilical cord prolapse happens when the umbilical cord precedes the fetus' exit from the uterus. It is an obstetric emergency during pregnancy or labor that imminently endangers the life of the fetus. Cord prolapse is rare.[1] Statistics on cord prolapse vary, but the range is between 0.14% and 0.62% of all births in most studies.[2]

Cord prolapse is often concurrent with the rupture of the amniotic sac. After this happens the fetus moves downward into the pelvis and puts pressure on the cord. As a result, oxygen and blood supplies to the fetus are diminished or cut-off and the baby must be delivered quickly.

Treatment and mortality rate

Some practitioners will attempt to reduce pressure on the cord and deliver vaginally right away. Frequently the attempt to resolve the prolapsed cord and deliver the baby vaginally fails, and an emergency caesarean section must be performed immediately.[3] While the patient is being prepared for a caesarean, the woman is placed in the Trendelenburg position or the knee-elbow position,[4] and an attendant reaches into the vagina and pushes the presenting part out of the pelvic inlet and back into the pelvis to remove the pressure from the umbilical cord.[5] If attempts to deliver the baby prompty fail, the fetus' oxygen and blood supply are occluded and brain damage or death will occur.

The mortality rate for the fetus is given as 11–17%.[6] This applies to hospital births or very quick transfers in a first world environment. One series is reported where there was no mortality in 24 cases with the novel intervention of infusing 500ml of fluid by catheter into the woman's bladder, in order to displace the presenting part of the fetus upward, and to reduce compression on the prolapsed cord[citation needed]; however a recent trial comparing manual support alone (n=29) versus manual support plus bladder-filling (n=15) showed no added benefit in terms of neonatal outcome.[7]

Risk factors

Potential predisposing risk factors include[8]:

References


Wikimedia Foundation. 2010.

Look at other dictionaries:

  • Umbilical cord — of a three minute old child. A medical clamp has been applied. Latin funiculus umbilicalis Code …   Wikipedia

  • prolapse — 1. To sink down, said of an organ or other part. 2. A sinking of an organ or other part, especially its appearance at a natural or artificial orifice. SEE ALSO: procidentia, ptosis. [L. prolapsus, a falling] p. of the corpus luteum ectropion of… …   Medical dictionary

  • prolapse of cord — premature expulsion of the umbilical cord in labor before the fetus is delivered …   Medical dictionary

  • Nuchal cord — Classification and external resources ICD 10 O69.1, P02.5 ICD 9 …   Wikipedia

  • Childbirth — Parturition redirects here. For the Voyager episode, see Parturition (Star Trek: Voyager). Childbirth (also called labor, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with the birth of one or more… …   Wikipedia

  • Breech birth — Infobox Disease Name = PAGENAME Caption = DiseasesDB = 1631 ICD10 = ICD9 = ICDO = OMIM = MedlinePlus = 002060 eMedicineSubj = med eMedicineTopic = 3272 eMedicine mult = eMedicine2|emerg|868 MeshID = A breech birth (also known as breech… …   Wikipedia

  • Coffin birth — Coffin birth, known in academia by the more accurate term postmortem fetal extrusion,[1][2] is the expulsion of a nonviable fetus through the vaginal opening of the decomposing body of a pregnant woman as a result of the increasing pressure of… …   Wikipedia

  • Amniotic band syndrome — Classification and external resources ICD 10 P02.8 ICD 9 762.8 …   Wikipedia

  • Chorioamnionitis — Classification and external resources Micrograph showing chorioamnionitis. The clusters of blue dots are inflammatory cells (neutrophils, eosinophils and lymphocytes). H E stain …   Wikipedia

  • Monoamniotic twins — Various types of chorionicity and amniosity (how the baby s sac looks) in monozygotic (one egg/identical) twins as a result of when the fertilized egg divides Monoamniotic twins are identical twins that share same amniotic sac within their… …   Wikipedia


Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”

We are using cookies for the best presentation of our site. Continuing to use this site, you agree with this.