Is Umbilical Cord Prolapse Dangerous? Let's Be Aware of This!

You know, the journey into this world can sometimes bring challenges for both you and your unborn baby. One of the most common and potentially dangerous situations that can occur when you are about to have a baby is when the umbilical cord comes out of the vagina before the baby is born. Doctors call this ``Umbilical Cord Prolapse``. Today, we will talk about many things in a simple and understandable way, such as what this really is, why it happens, and what to do if it happens.

What does it mean when the umbilical cord comes out early?

Simply put, this happens when you are about to have a baby, either right after your water breaks or just before the baby is about to come out, and the umbilical cord comes out of your cervix and into your vagina before the baby. Normally, when a baby is born, the baby comes out first, and then the umbilical cord comes out. But in this condition called ``Umbilical Cord Prolapse``, the umbilical cord comes out first. Imagine what happens when that happens? The umbilical cord that has come out has a lot of space to get stuck between the baby's body, your cervix, and your vagina.

What is the function of the umbilical cord?

Now you're probably wondering, "What's so special about the umbilical cord?" The umbilical cord is like a flexible tube. It's what carries the nutrients and oxygen your baby needs throughout your pregnancy. It's like the baby's lifeline.

What happens if the umbilical cord comes out early?

The premature exit of the umbilical cord is considered a medical emergency . Do you know why? Because when this happens, the umbilical cord can become trapped and the baby's blood and oxygen supply can be cut off. Imagine, when the baby's head or body presses on the umbilical cord, just like when a water pipe is bent, the water stops flowing, and the baby's nutrition stops. Not only that, but when you have contractions to deliver the baby, the uterus tightens even more. Then the umbilical cord can become even more trapped. Sometimes, when the umbilical cord comes out of the vagina and is exposed to air, the blood vessels in it can constrict and reduce blood flow. For these reasons, the baby is more likely to have serious, possibly life-threatening, disabilities .

Are there any types of premature umbilical cord emergence?

Yes, this can be divided into two main types: 1. Overt prolapse: In this case, the umbilical cord comes out through the cervix and into the vagina before the baby, and may even be visible outside the vagina. 2. Occult prolapse: In this case, the umbilical cord does not come out before the baby, but when the baby comes out, the umbilical cord may be pressed against the baby's body, that is, against the baby's head or shoulders. This is a little difficult to recognize because it is not visible outside.

How common is this condition?

Umbilical Cord Prolapse is not a very common condition. It is usually said that it occurs in about one in 300 births. However, some new studies suggest that this number may be even lower, perhaps as low as one in 1,000 births. However, it is important to remember that even though it is rare, it is still dangerous if it occurs .

What are the main symptoms of prematurely emerging umbilical cord?

There are two main reasons your doctor or nurse might be suspicious about something like this:

• If, after your water breaks, you can feel or see the umbilical cord when you examine it.
• If the baby's heart rate suddenly slows down, beats too fast, or changes in an unusual way.

However, sometimes this can happen without any outward symptoms. One study found that more than half of these premature cord prolapses occur within five minutes of the water breaking, and about 70% occur within an hour of the water breaking.

Important: If you feel anything strange after your water breaks, or if you are concerned about what the doctor says, be careful.

What are the reasons why the umbilical cord comes out early?

It's hard to say exactly what causes this. But there are several factors that increase the risk. Most of the time, this happens after the water breaks, and doctors know that the fluid inside the uterus (amniotic fluid) leaks out. But that's not the only reason. There are several main factors that contribute:

• Breech presentation: This means that the baby is in a position other than the head down. This means that the baby's buttocks or legs are facing down.
• If you are expecting twins or triplets, you are having a ``multiple pregnancy ''.
• Polyhydramnios is the presence of too much amniotic fluid in the uterus.
• Premature rupture of membranes.

Who is most at risk?

Umbilical Cord Prolapse can occur without any risk factors. However, there are certain conditions that make it more likely to occur. In addition to the aforementioned causes, there are several other risk factors:

• Some diseases that occur at birth in the baby are called ``Fetal congenital disorders``.
• Placenta previa is when the placenta is located low in the uterus.
• Abnormal shape of the umbilical cord (for example, too long, too thin).
• Assisted vaginal delivery involves using equipment such as a vacuum or forceps when delivering the baby.
• Low birth weight (birth weight less than 2.5 kg).
• If you have given birth to more than five children before (multiparous).
• Abnormalities in the way the umbilical cord is attached to the placenta (Velamentous cord insertion).
• The baby is positioned too high in the uterus (high fetal station - how low the baby is in the pelvis as labor approaches).
• A baby that is larger than normal is called ``Macrosomia''.
• When doctors do things like break the bag of water (Amniotomy) or inject medicine to open the cervix quickly (cervical ripening balloon).

What are the dangerous complications that can arise from this?

Although premature cord prolapse is uncommon, it can be a life-threatening emergency. If the cord becomes compressed, the baby will not get enough oxygen. Therefore, immediate treatment is necessary. Otherwise, serious consequences may occur. Complications that can occur include:

• Lack of oxygen to the baby (Hypoxia).
• Brain damage due to lack of oxygen (Hypoxic-ischemic encephalopathy - HIE) or (Birth asphyxia)
• Conditions like cerebral palsy .
• Permanent brain damage .
• Stillbirth.

These things can be scary to hear. But remember, these things happen very rarely. And, if something like this happens in a hospital, doctors will act quickly.

How do doctors first recognize this?

This is how the medical team usually diagnoses this condition:

• When examining the vagina , the umbilical cord can be felt or seen.
• Abnormally slow baby's heart rate (`(Bradycardia)` - that is, less than 120 beats per minute).
• Seeing a sudden change in your blood pressure.

What is the treatment for premature umbilical cord?

Because this is an obstetric emergency, the baby often needs to be delivered quickly. The safest and quickest way to deliver the baby is usually by cesarean section (C-section). The medical team will first try to relieve the cord compression. This may involve turning you into a knee-to-chest position, or a doctor may try to lift the baby slightly to release the cord. This will temporarily reduce the risk of oxygen deprivation. However, the baby must be delivered as soon as possible to save the baby's life. If the cord compression problem can be resolved quickly, the baby can be saved without any harm. However,The longer the delay, the greater the chance of complications.

Is there a way to prevent the umbilical cord from coming out early?

Unfortunately, there is no specific way to prevent this. Also, it is difficult to detect it early during pregnancy. Because the umbilical cord and the baby are constantly moving around inside the womb. The only thing the medical team can do is to act quickly if this `(Umbilical Cord Prolapse)` occurs.

Can the baby survive if the umbilical cord comes out early?

Yes, babies can often be saved from this condition. If this happens in a hospital, the baby's mortality rate is said to be about 3% (some studies say it's as high as 7%). However, if this happens outside the hospital, that is, at home, the situation is dire. In such cases, the risk of death is about 20 times higher. Premature cord prolapse is a rare, unavoidable, emergency birth condition. If your medical team recognizes this, they will work to deliver your baby as soon as possible. While there is nothing you can do to prevent this from happening, being aware of the risk factors and knowing what to do if it happens can help you in this rare event.

Things we need to remember from this

Okay, so, there are a few things you should take into account from what we've talked about.

• Umbilical Cord Prolapse is a sudden and potentially serious condition.
• This cannot be prevented , and it is also difficult to detect early during pregnancy.
• If, after your water breaks, you feel something coming out of your vagina, or if you notice a sudden change in your baby's movements, go to the hospital or seek medical advice immediately .
• This happens very rarely, so don't be unnecessarily scared.
• However, if something like this happens in a hospital, the medical team will work to save the baby as quickly as possible. Therefore, having a baby in a hospital is the safest option in such a situation.

We sincerely hope that your pregnancy will be comfortable and that you will bring a healthy baby into this world!