Definition
Cord prolapse is a relatively rare obstetrical emergency, but is associated with neonatal morbidity and mortality. This occurs when the umbilical cord can be felt or seen in or outside the vagina. It can be either between the fetal presenting part and the cervix or alongside the presenting part.
Risk factors
Risk factors of cord prolapse include:
- Multiple gestations
- Polyhydramnios
- Malpresentation, high presenting part
- Small for gestational age fetus
- Prematurity
- Premature rupture of membranes
- Placenta previa
- Grand multiparity
- Iatrogenic- including artificial rupture of membranes, fetal scalp sampling, mechanical induction with foley catheter, ECV, manual rotation of head
Cord prolapse often occurs when the presenting part is not fixed in the pelvis. During artificial rupture of membrane, care should be taken to slowly release fluid and ensure the fetal head is well applied to the cervix afterwards.