UMBILICAL CORD PROLAPSE
PRESENTED BY
MOHAMMED HAROON RASHID

• The umbilical cord is a flexible, tube-like structure that, during
pregnancy, connects the fetus to the mother.
• The umbilical cord is the baby's lifeline to the mother.
• It transports nutrients to the baby and also carries away the
baby's waste products.
• It is made up of three blood vessels – two arteries and one vein.
WHAT IS THE UMBILICAL CORD?

• 1 vein that carries blood rich in oxygen and nutrients from you
to your baby
• 2 arteries that return deoxygenated blood and waste products,
such as carbon dioxide, from your baby back to the placenta
• The umbilical cord connects a baby in the womb to its mother. It
runs from an opening in your baby's stomach to the placenta in
the womb. The average cord is about 50cm (20in) long.
WHAT IS THE UMBILICAL CORD?

PLAY VIDEO

• Umbilical cord prolapse occurs when the umbilical cord comes out
of the uterus with or before the presenting part of the fetus.
• It is a relatively rare condition and occurs in fewer than 1% of
pregnancies.
• Cord prolapse is more common in women who have had rupture of
their amniotic sac.
• Whenever there is a sudden decrease in fetal heart rate or abnormal
fetal heart tracing, umbilical cord prolapse should be considered.
• Due to the possibility for fetal death and other complications,
umbilical cord prolapse is considered an obstetric emergency during
pregnancyor labor.
UMBILICAL CORD PROLAPSE

• Umbilical cord prolapse is when, during labor, the umbilical
cord comes out of the uterus with or before the presenting
part of the baby
• Other risks include a premature or small baby, twin
pregnancy, and too much amniotic fluid.
• This umbilical cord compression can either occur during
pregnancy or during labor. Umbilical cord compression occurs
in approximately 1 in 10 deliveries.
• Umbilical cord compression can cause changes in your baby’s
blood pressure due to the changes in heart rate and lack of
oxygen.
• Umbilical cord compression can be diagnosed before labor by
one of two doctors test; either a fetal Doppler or
an ultrasound.
UMBILICAL CORD PROLAPSE

PLAY VIDEO

DEFINITION OF U.C.P
Umbilical cord prolapse is a complication that
occurs prior to or during delivery of the baby. In a
prolapse, the umbilical cord drops (prolapses)
through the open cervix into the vagina ahead of the
baby. The cord can then become trapped against the
baby's body during delivery. Umbilical cord
prolapse occurs in approximately one in every 300
births.
According to “encyclopedia”

DEFINITION OF U.C.P
In overt umbilical cord prolapse, the cord slips
ahead of the presenting part of the fetus and
protrudes into the cervical canal or vagina, or
beyond. It is an obstetrical emergency because the
prolapsed cord is vulnerable to compression,
umbilical vein occlusion, and umbilical artery
vasospasm, which can compromise fetal
oxygenation.
According to “wikipedia”

The incidence of umbilical cord prolapse ranges from 0.1-
0.6% of all pregnancies.
Arecent study estimates 77% of cord prolapses occur in
singleton
pregnancies, or those where there is only one fetus.
In twin pregnancies, cord prolapses occur more frequently in the
second twin to be delivered, with 9% in the first twin and 14%
in the second twin.
1 in 300 deliveries
EPIDEMIOLOGY

ANATOMY & PHYSIOLOGY

TYPES OF UMBILICAL
CORD PROLAPSE

1. Overt Umbilical Cord Prolapse
descent of the umbilical
cord past the presenting
fetal part. In this case, the
cord is through
the cervix and into or
beyond the vagina. Overt
umbilical cord prolapse
requires rupture of
membranes. This is the
most common type of cord
prolapse.

2. Occult Umbilical Cord Prolapse
descent of the umbilical
cord alongside the
presenting fetal part, but
has not advanced past the
presenting fetal part.
Occult umbilical prolapse
can occur with both intact
or ruptured membranes.

3. Funic (Cord) Umbilical Cord Prolapse
presence of the umbilical
cord between the
presenting fetal part and
fetal membranes. In this
case, the cord has not
passed the opening of the
cervix. In funic
presentation, the
membranes are not yet
ruptured.

CAUSES OF UMBILICAL
CORD PROLAPSE

1. Premature delivery of the baby

2. Delivering more than one baby per
pregnancy (twins, triplets, etc.)

3. Excessive amniotic fluid
Polyhydramnios

4. Breech delivery (the baby comes through
the birth canal feet first)

5. An umbilical cord that is longer than usual

6. Multiparity

7. Congenital Anomalies

8. Contracted Pelvis

The pathogenesis of umbilical cord prolapse is not always clear.
One probable mechanism is high outward flow of amniotic fluid at rupture of
membranes that carries the umbilical cord past an unengaged fetal presenting
part.
Another probable mechanism is disengagement of the presenting part during
obstetric procedures, allowing the cord to prolapse.
PATHOGENESIS

SIGN & SYMPTOM OF
UMBILICAL CORD PROLAPSE

1. The first sign of an
umbilical cord prolapse
is typically a decrease in
the baby’s heart rate as
indicated by a fetal
monitor. A fetal heart
rate less than 120 beats
per minute can be a sign
of a prolapsed or
compressed umbilical
cord.

2. Foetal distress due to lack of oxygen

3. Decrease in the foetal heart rate for a long
duration

4. Compression of umbilical cord

5. Polyhydramnios

6. examination where the doctor attempts to
visualize or palpate the cord with their fingers.

7. The most obvious symptom
of a prolapsed umbilical cord
is seeing or feeling the cord
before the baby is
delivered. Fetal
distress from lack of
oxygen can also be observed
as a sudden and prolonged
fetal heart rate deceleration on
the fetal monitor. This can
also be a sign of other equally
serious delivery problems and
requires immediate attention
from medical staff.

DIAGNOSTIC EVALUATION
UMBILICAL CORD PROLAPSE

1. Feeling the cord dropping into the vagina or
your midwife seeing the cord come out before the
presenting part of the baby are the most obvious
ways to confirm a UCP.

2. Pelvic Or Vaginal examination

3. Doppler ultrasound imaging Fetal heart rate on a fetal
Doppler following the waters breaking (A prolapse is
suspected in case it suddenly drops below 120 beats a minute,
as it might indicate a lack of oxygen supply through the cord.)

4. An ultrasound scan performed before delivery to
check the cord compression may also detect the
problem.

5. Prenatal ultrasound scans are able to detect any
abnormality in the developing fetus. If umbilical cord
prolapse is detected, it will show an abnormal position
of the cord in the birth canal.

MANAGEMENT OF
UMBILICAL CORD PROLAPSE

1. Medical Management
2.Surgical Management
3.Nursing Management

1. CORD MANAGEMENT
C - Call of Help
O - Organized For Delivery
R - Relieve Pressure
D - Delivery

2. Manual elevation of the presenting fetal
part And Repositioning of the mother to be
head down with feet elevated.

SURGICAL
MANAGEMENT

A cesarean delivery — also known as a C-section or
cesarean section — is the surgical delivery of a baby.
It involves one incision in the mother’s abdomen and
another in the uterus.
It’s a common procedure that’s used to deliver nearly
one-third of babies in the United States, according to
the Centers for Disease Control and Prevention.
1. A lower (uterine)
segment Caesarean section (LSCS)

Reasons for a cesarean delivery include:
1.baby has developmental conditions
2.baby’s head is too big for the birth canal
3.the baby is coming out feet first (breech birth)
4.early pregnancy complications
5.mother’s health problems, such as high blood
pressure or unstable heart disease
6.problems with the placenta, such as placental
abruption or placenta previa
7.problems with the umbilical cord
8.reduced oxygen supply to the baby

Please Playing Video For Lscs

NURSING
MANAGEMENT

PREVENTION

COMPLICATION

COMPLICATION

ANY DOUBT PLEASE ASK ME
I’M TRYING TO ANSWER YOUR
QUESTION

THANK YOU ALL OF
YOU