Cord prolapse is a complication that can occur during labor, usually just before or during delivery. It happens when the umbilical cord drops (prolapses) out of its normal position and comes out of the cervix before the baby. In a typical delivery, the baby comes out first, followed by the umbilical cord. But in a prolapse, the umbilical cord drops through the cervix and into the vagina before the baby does. When this happens, the umbilical cord can get squished between the babys body and the cervix or vagina, which can cut off the babys blood and oxygen supply during delivery.

Cord prolapse can be overt or occult (nonovert) . An overt prolapse means that the cord slips down into the cervix and vagina ahead of the baby during delivery. In an occult umbilical cord prolapse, the cord slips out alongside (not before) the baby.

Cord prolapse is a medical emergency because it can cause severe and permanent disabilities. The longer the delay in treatment, the greater the risk of complications such as placental abruption, excessive bleeding, fetal injuries, and stillbirth. A common cause of cord prolapse is premature rupture of the membranes, which is when a mothers water breaks before shes actually in labor and her babys head has begun to "engage," or settle into, the birth canal. Other risk factors include having twins or multiples, having previous children, a low-lying placenta, atypical placental cord insertions, uterine malformations (such as fibroids), polyhydramnios (too much amniotic fluid), having a long umbilical cord, and prolonged labor. Obstetric interventions associated with cord prolapse include induction of labor due to cervical ripening with a balloon catheter or artificial rupture of membranes, and use of forceps or a vacuum.

Cord prolapse can be diagnosed at a medical examination. You may feel the cord in your vagina or your health professional may feel it during a vaginal exam. For some women, the only sign of a prolapsed umbilical cord is that the baby has an unusual heart rate. An unusual heart rate in your unborn baby can occur in up to 67% of prolapsed umbilical cord cases. This happens because the cord is stretched and compressed, slowing dow...