Patrick Muffley

Umbilical Cord Prolapse by Dr. Patrick Muffley An obstetric emergency that occurs during labor when the umbilical cord exits the uterus before the fetus, umbilical cord prolapse occurs in 0.14% to 0.62% of births and places the life of the fetus in immediate danger. Prolapses can occur either overtly, with the umbilical cord visible or palpable upon examination, or occultly, with it descending alongside part of the fetus and therefore impossible to observe. Both types of prolapse endanger the life of the child because they are usually accompanied by compression of the umbilical cord between the fetus and the mother’s body, compromising blood flow to the baby. Umbilical cord prolapse typically occurs after the rupture of the amniotic sac and cannot be predicted. Risk factors for cord prolapse include having twins or triplets, early breaking of the amniotic sac, or a having a fetus in the transverse position when the amniotic sac is broken. A woman and her doctor will know the cord has prolapsed if they can see or feel it or the baby’s heart rate slows after the water breaks. The most immediate concern in an umbilical cord prolapse is to prevent or relieve pressure on the umbilical cord. A woman may be asked to get onto her knees and place her elbows and hands on the floor, then lower her head to prevent pressure on the cord. A doctor or assistant may lift the baby’s head inside the vagina to keep it from putting pressure on the cord. Umbilical cord prolapse always calls for immediate delivery of the child, through either a cesarean section or vaginal birth. Luckily, most babies suffer no long-term damage from a prolapse, though the risk of brain damage and death does exist. About the author: Dr. Patrick Muffley presently serves as an attending obstetrician and gynecologist (OB-GYN) at Embody Wellness Obstetrics & Gynecology in Columbus, Ohio. Dr. Muffley has worked as an OB-GYN for more than a decade. His publications include numerous book chapters and articles on topics in women’s health, including umbilical cord prolapse.