Umbilical Cord Prolapse & Compression*

In a normal delivery, the baby exits the mother before the umbilical cord. With umbilical cord prolapse, this order is reversed, often when the mother’s ‘water breaks’ and the baby is moving into the birth canal. This is an obstetrical emergency because the cord is at high risk for compression, blocking oxygen and blood flow to the baby. In these cases, an emergency C-section is often necessary, with recommendations stating that they should occur less than 12 minutes from the onset of signs of fetal distress.

Prolapsed cord is considered an obstetrical emergency because the cord can become compressed between the baby’s body and the uterus, cervix, or pelvis during delivery. If this occurs, the oxygen and blood to the baby can be partially blocked or completely cut off and the baby must be delivered immediately.

Medical Explanations

Umbilical Cord Prolapse: Types

There are two types of umbilical cord prolapse:

  • Overt prolapse. This is the most common type of cord prolapse. It happens when the cord comes out of the cervix or vagina before the presenting part of the baby and is either visible or able to be felt by the medical practitioner.
  • Occult prolapse. This happens when the cord descends alongside but not past the presenting part of the baby. It can happen with ruptured or intact membranes.

umbilical-cord-prolapse

Causes and Signs of Umbilical Cord Prolapse

There are several causes of umbilical cord prolapse. They include:

  • Premature rupture of the membranes. This is the most common cause. If a physician ruptures the membranes  too early, the baby’s head is too high up in the uterus. The fluid loss and unengaged position of the baby’s head in the cervix allows the umbilical cord to precede the baby. The cord can then become compressed as the baby descends.
  • Premature delivery.
  • Delivery of multiples (twins, triplets, etc.). The first baby may push out the cord of another baby upon exiting the mother.
  • Abnormally long cord.
  • Excessive amniotic fluid. When there is a large volume of fluid, the cord can be forced out before the baby due to the pressure of the fluid exiting the mother.
  • Unusual delivery presentation. This would include a breech position where the baby comes through the birth canal feet first allowing space for the cord to slip through before the feet.

The most obvious symptom of a prolapsed umbilical cord is seeing or feeling the cord before the baby is delivered. Fetal distress from lack of oxygen can also be observed  as a sudden and prolonged fetal heart rate deceleration on the fetal monitor. As this can be a sign of other equally serious delivery problems, it requires immediate attention by medical staff.

Treatment for Umbilical Cord Prolapse

Once a prolapse is diagnosed, it requires rapid delivery. In some cases, a physician will try to move the baby away from the cord in order to relieve the pressure and reduce the risk of oxygen deprivation while attempting to deliver the baby vaginally, sometimes with the help of forceps or a vacuum extractor. Often this course of action doesn’t work and an emergency C-section is performed immediately. Generally, while the mother is prepared for the surgery, the presenting part of the baby is pushed back into the pelvis to continue to relieve the pressure from the cord.

It is important for the emergency C-section to happen quickly. If the delivery is not prompt, there is the potential that the foetus’ oxygen and blood supply will be diminished or completely interrupted. This may result in brain damage or death. According to “Obstetrics: Normal and Problem Pregnancies,” 5th edition by Steven G. Gabbe, research indicates that permanent brain damage occurs rapidly when oxygen is completely cut off. When asphyxiation occurs for 7-12 minutes, motor and behavioral changes occur with some scarring of the brain. In cases where there is a lack of oxygen for 12-17 minutes, severe neurological damage occurs, often death. Therefore, the recommendation is for delivery to occur in less than 12 minutes from the onset of the heart rate decelerations to avoid permanent damage.

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Your Legal Options

Legal Help

If you or a loved one suffered permanent damage from an umbilical cord complication, we encourage you to contact a law firm with experience in these types of complex cases. Medical Law was established to focus exclusively on birth injury cases. Since the firm’s inception, our legal team has addressed the special needs of our clients in a variety of birth injury, pregnancy and newborn medical negligence cases. Our solicitors and medical advisors determine the causes of our clients’ injuries, the prognoses of birth injured children and areas of medical negligence.

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Medical Law:   Our Priorities
As experienced solicitors, we know how to pursue these kinds of Umbilical Cord claims.  We understand the needs of our clients.   We can employ the resources to be effective in complex medical negligence litigation.
Medical Law:  Our Promise to You
We are dedicated to the service of our clients from our initial consultation and case review until we reach a settlement or judgment on your behalf.   Your best interests are our priority.  If you or a loved one have suffered due to medical negligence, we want to help you by finding out, what happened, who was responsible and holding that responsible party or parties to account.

*In contentious business a solicitor may not calculate fees or other charges as a percentage or proportion of any award or settlement. This statement is made in compliance with Regulation 8 of S.I. 518 of 2002.

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Medicallaw.ie is a team of experienced solicitors and medical consultants who specialise in taking on medical negligence claims.

The team is headed up by Siobhan Fahy, Solicitor.

We are all well qualified in our respective fields and have years of experience in the area of medical negligence. We seek justice and financial compensation for patients who feel that they have been the victim of medical neglect.

We recognise the dedication of those who serve in our hospitals and health service, but the reality is that our health system is so inadequate that many people find they have become victims of a particular consultant or the Health Service Executive itself. We are here to help.

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