Why Umbilical Cord Prolapse Is a Medical Emergency

The umbilical cord is a baby’s lifeline. It connects a developing fetus to the placenta during pregnancy. Its main function is to provide the fetus with oxygen and nutrients from the mother’s bloodstream and to remove waste products from the fetus’s blood. When a mother gives birth, the baby is born first followed by the umbilical cord. Shortly after birth, the umbilical cord is usually clamped and cut, separating the newborn from the placenta. The stump of the umbilical cord then gradually dries out and falls off within a few weeks, leaving behind the belly button.

However, if the umbilical cord falls through the open cervix into the vagina before the baby moves into the birth canal, the cord is squeezed between the baby and the mother’s pelvic bones, leading to a dangerous, unpreventable, and unpredictable condition known as umbilical cord prolapse.

What is umbilical cord prolapse?

Umbilical cord prolapse is a rare but potentially serious obstetric emergency that happens when the umbilical cord drops into the birth canal before or alongside the fetus (usually the head). Umbilical cord prolapse can happen during labor or delivery, and may lead to compression of the cord, which can reduce or block the flow of oxygen and nutrients to the fetus.

There are two main types of umbilical cord prolapse:

• Overt prolapse: Occurs when the umbilical cord is visible or can be felt protruding from the vagina.
• Occult prolapse: Occurs when the cord falls down alongside the fetus within the uterus but does not protrude through the vagina. Occult prolapse is not visible but can still pose risks to the fetus.

Some common risk factors for umbilical cord prolapse include:

• Breach presentation: The unborn baby’s feet or buttocks point toward the birth canal.
• Polyhydramnios: Excessive amniotic fluid surrounds the unborn baby.
• Multiple gestation: Carrying twins or other multiples increases the risk.
• Premature birth: Delivery before 37 weeks of gestation is considered pre-term.
• Membrane rupture: The amniotic sac breaks prematurely.
• Medical procedures: This includes when the doctor breaks the amniotic sac while dilating the cervix.

Medical providers must be aware of the presence of these risk factors, but the occurrence of cord prolapse is rare and unpredictable, occurring in approximately one to six per 1000 deliveries (0.2 percent in the U.S.), and sometimes happens to mothers who don’t have any risk factors. Symptoms and signs of umbilical cord prolapse include sudden fetal heart rate abnormalities occurring during labor and feeling or seeing the umbilical cord protruding from the vagina. For some mothers, the only sign of umbilical cord prolapse sudden changes in their baby’s heart rate that happen because the umbilical cord is stretched and compressed, reducing blood flow to the baby.

Steps to take if you suspect umbilical cord prolapse

Umbilical cord prolapse requires immediate medical attention to reduce the risk to the baby. The primary goal for medical professionals is to relieve pressure on the umbilical cord and deliver the baby as quickly and safely as possible. If the umbilical cord is protruding out of the vagina, the time between diagnosis of umbilical cord prolapse and the delivery of the baby should not exceed 30 minutes. If the mother is in the first or early second stage of labor, a Cesarean section (C-section) is typically recommended. However, depending on the circumstances, vaginal delivery might be faster.

Prompt recognition and management of umbilical cord prolapse are critical as a delay in care dramatically increases the chances of brain damage or death. According to the Cleveland Clinic, when umbilical cord prolapse occurs outside a hospital, the baby’s risk of death is about 20 times higher than if it happens in the hospital. Anyone suspecting or experiencing symptoms of umbilical cord prolapse should seek immediate medical attention.

Can umbilical cord prolapse be caused by medical malpractice?

The short answer is, no. Umbilical cord prolapse occurs spontaneously during pregnancy or childbirth. However, there are cases where medical negligence or malpractice may contribute to the risk of severe complications when it occurs. Here are some scenarios where malpractice may be related to a poor outcome for the baby:

• Failure to monitor: If healthcare providers fail to properly monitor the fetus during labor, including monitoring fetal heart rate patterns, they may miss signs of umbilical cord prolapse or fetal distress.
• Inappropriate interventions: Certain medical interventions, such as artificial rupture of the membranes (amniotomy) or forceps/vacuum-assisted deliveries, can increase the risk of cord prolapse. If these interventions are performed without appropriate monitoring for the risk of umbilical cord prolapse, it could be considered malpractice.
• Delayed diagnosis: A delay in diagnosing umbilical cord prolapse can result in prolonged oxygen deprivation and potential harm to the fetus. If medical staff fail to recognize the signs of cord prolapse and take prompt action, it could be a case of negligence.
• Improper management: Once umbilical cord prolapse is diagnosed, immediate action must be taken to relieve pressure on the cord and deliver the baby quickly. If medical staff fail to manage the situation appropriately, it could lead to complications and may be considered malpractice.
• Failure to recognize risk factors: Healthcare providers should assess the mother and fetus for known risk factors for umbilical cord prolapse, such as polyhydramnios, fetal malpresentation, or multiple gestation. Failure to identify and manage these risks could be seen as negligence.

It is tragic when a medical professional makes a mistake and causes harm to a patient. If you believe that umbilical cord prolapse occurred due to medical negligence, you need to consult with an experienced Kentucky medical malpractice attorney who can review the details of your case, gather expert opinions, and help determine whether there is evidence of medical negligence.

The Kentucky medical malpractice lawyers at Wilt Injury Lawyers are ready to advocate for your rights. If you believe that you or someone you love sustained umbilical cord prolapse due to a medical provider’s negligence, call us or fill out our contact form to set up your free consultation. We proudly serve client throughout Kentucky, and maintain offices in Lexington and Louisville. Call today.