If you are expecting a baby, you have probably heard a lot about childbirth. Usually, the baby comes into the world first, and then the umbilical cord and placenta come out. However, it is very rare for the umbilical cord to come out of the vagina before the baby comes out. This is what we medically call an umbilical cord prolapse . Although this can be a bit scary, it is important to be aware of this.
Simply put, what does this mean?
Think about it, the umbilical cord is the lifeline of a baby in the womb. This tube-like structure connects the baby to the placenta. The blood vessels inside it supply the baby with oxygen-rich blood and nutrients. It also removes waste products from the baby's body.
So, in an ``Umbilical Cord Prolapse``, the umbilical cord slips into the vagina when the cervix opens before the baby enters the birth canal. When this happens, the umbilical cord gets stuck between the baby's body and your pelvic bones. Think of it like someone stepping on a water pipe and the water stops flowing.
When the umbilical cord is clamped in this way, the blood flow to the baby is cut off. This means that the amount of oxygen the baby receives is suddenly reduced. This is a very dangerous emergency for the baby.
If this happens, the baby should be delivered as soon as possible to prevent any potential harm to the baby's life. This condition is very rare. It occurs in about one in 1,000 births. However, it is important to be aware of this because of its seriousness.
Who is most at risk?
Mothers with certain pregnancy complications are more likely to develop this ``Umbilical Cord Prolapse.`` Let's see what it is.
| Risk Factor | Simply explained |
|---|---|
| Having twins or more children in the womb | Because there is more room in the womb, the umbilical cord may have room to descend after the first baby is born. |
| Preterm labor | When the baby is born prematurely, the baby's head is not properly positioned in the pelvis, so it can slip into the umbilical cord. |
| Low birth-weight | Because the baby is small, there is more room near the cervix and the umbilical cord can descend. |
| Breech presentation | When the baby's buttocks or legs are down instead of the head, those parts don't close the cervix properly. The umbilical cord can come down through that gap. A study has shown that this is the reason for 36.5% of such cases. |
| Increased amniotic fluid (Polyhydramnios) | When the amount of water around the baby increases too much, the umbilical cord can quickly come down with the water as the bag of waters breaks. |
| Preterm rupture of membranes | If the water breaks before 37 weeks, the baby's head has not yet fully descended, allowing room for the umbilical cord. |
Additionally, this risk can also arise during certain medical procedures . For example, in cases where the doctor breaks the bag of water (amniotomy), there is this risk if the baby's head is not properly positioned.
How do doctors detect this?
This condition is diagnosed during a medical examination. You may feel something like a string being pulled through your vagina. Or you may feel it when a doctor or nurse examines you.
However, most of the time, this is detected by a change in the baby's heart rate. The baby's heart rate suddenly slows down abnormally. This is because, when the umbilical cord is clamped, the baby's blood flow decreases, causing the baby to be stressed and have a change in heart rate. This is the first sign in 67% of cases.
What do you do if something like this happens at home?
If you're at home and your water breaks and you feel something like a string coming out of your vagina, it's an emergency .
- Call an ambulance immediately. Don't waste time.
- Until the ambulance arrives, there is one very important thing you can do. Keep your knees and hands on the ground, chest as close to the ground as possible, and your buttocks elevated. This position reduces the force of gravity on the umbilical cord, which reduces the pressure on it. This helps to prolong the time the baby gets oxygen.
How is it treated?
If you detect that the umbilical cord has come out of the vagina, the only thing to do is to deliver the baby as soon as possible. Experts say that the baby should be delivered within 30 minutes of the time this is detected.
- Emergency Cesarean section: Most of the time, if this situation occurs in a mother who is in the early stages of labor, an emergency cesarean section (C-section) is performed immediately.
- Vaginal delivery: In some cases, for example, if a mother is nearing full term, it may be possible to deliver the baby vaginally rather than having to prepare for a cesarean section. In that case, doctors will choose the fastest method.
While preparing for surgery, the medical staff at the hospital do several things.
- You are in a knee-to-chest position.
- The doctor or a trained person will place their hand in the vagina and gently lift the lower part of the baby's head to prevent the umbilical cord from getting stuck. This is done until the surgery begins.
- Sometimes, your bladder is filled with saline solution, which helps push the baby's head up and relieves pressure on the umbilical cord.
Remember, every second that treatment is delayed increases the risk of life or brain damage to the baby. If something like this happens outside the hospital, the potential harm to the baby is about 18 times greater than if it happens in a hospital. That's why we say to go to the hospital immediately if there is a risk or if labor has begun.
Is there a way to prevent this?
This is a question that many people ask. The straight answer is no. There is no way to prevent this. Also, it is not possible to predict whether it will happen in advance. Since the umbilical cord moves around a lot during pregnancy, even a scan cannot tell whether it will happen or not. It can happen even to someone who has no risk factors.
However, if you have any of the risk factors mentioned above (for example, if your baby is in a breech position), your doctor may advise you to stay in the hospital until you are close to going into labor. This way, if there is an emergency, the medical staff can respond immediately. Therefore, it is important to follow your doctor's instructions.
Take-Home Message
- Umbilical Cord Prolapse is a rare but very dangerous medical emergency.
- The biggest danger here is that the baby's oxygen supply is cut off due to the umbilical cord being pinched.
- If you feel a string-like object coming out of your vagina after your water breaks, consider it an emergency and go to a hospital or call an ambulance immediately.
- If you encounter this situation at home, you can reduce pressure on the umbilical cord by immediately placing your knees and hands on the floor and keeping your buttocks elevated (knee-chest position).
- Although this cannot be prevented in advance, if you have risk factors such as `(breech presentation)`, talk to your doctor to decide on the safest birth plan. It is very important to follow medical advice.
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