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umbilical cord prolapse

Birth injuries, while rare, have the potential to completely change the course of the lives of both mother and baby. Umbilical cord prolapse is one such birth injury. Although it only occurs in around 1% of all pregnancies, it has a very high mortality rate – around 50%. It is a very dangerous and abnormal obstetric emergency that doctors and nurses must handle quickly. If a healthcare provider fails to react appropriately, it could result in fetal brain damage, perinatal death, or other birth injuries such as cerebral palsy, Erb’s palsy, and uterine rupture.

If your baby suffered a birth injury or died because of a doctor’s failure to properly handle your prolapsed umbilical cord, you might have a valid birth injury lawsuit. Call Reich & Binstock as soon as possible. Our Houston birth injury lawyers have extensive experience handling a wide array of personal injury cases, including birth injuries. We also offer a free initial consultation in which we can discuss and evaluate your case. To schedule your consultation with a Houston personal injury lawyer, please call 713-622-7271 today.

What Is Umbilical Cord Prolapse (UCP)?

In a normal fetal presentation, the baby is delivered before the umbilical cord. However, in abnormal fetal presentation, the umbilical cord could prolapse. This means that the cord falls out of the normal position, often through the cervix and the vagina ahead of the baby.

It’s important to understand that the umbilical cord is a baby’s lifeline to the mother. It is a tube-like structure that carries oxygen-rich blood and nutrients to the baby through blood vessels, as well as removes waste from the baby. Therefore, if umbilical cord prolapse occurs, it could greatly affect the baby’s health.

When UCP happens, the cord is jammed between the body of the baby and the maternal pelvis. This reduces the blood flow to the baby, which reduces their oxygen supply. UCP is a potentially fatal obstetric emergency that must be dealt with quickly to avoid complications associated with poor oxygen supply.

What Is Umbilical Cord Compression?

Many people confuse umbilical cord compression with umbilical cord prolapse, but they are very different. It occurs when the weight of the baby, the vaginal walls, or even the placenta place pressure on the cord. This can happen during labor, delivery, or general pregnancy. It is much more common than umbilical cord prolapse, occurring in around 10% of deliveries.

Particularly during the later stages of pregnancy, a baby can shift positions and put some pressure on the umbilical cord. However, simply shifting positions again can correct the problem. Doctors are expected to monitor the baby’s heart rate via ultrasound. Any abnormal fetal heart rate could signal that there is pressure on the cord.

It is then the doctor’s job to relieve cord compression by using a number of techniques we discuss below. In rare cases, the situation might require immediate delivery through an emergency cesarean section.

What Causes a Prolapsed Umbilical Cord?

The most common cause of umbilical cord prolapse is premature rupture of membranes. This is also called preterm premature rupture of membranes. It occurs when the mother’s water breaks too early, and the baby’s head starts to move into the birth canal. Below, we list other causes of this obstetric emergency.

  • Having more than one baby in one pregnancy, such as having twins or triplets
  • Excessive amniotic fluid
  • Premature rupture of fetal membranes
  • Fetal presenting in breech position (feet first)
  • Premature birth
  • Low birth weight
  • Artificial rupture of membranes
  • Rotation of the fetal head manually
  • Placing an internal monitor, such as a catheter, in the mother

What Are the First Signs of Cord Prolapse?

One of the first signs of umbilical cord prolapse is a sharp and sudden decrease in the fetal heart rate. If the fetal heart rate does not immediately raise, this is a good indicator of cord compression. Other signs and symptoms include: feeling the umbilical cord in the mother’s vaginal canal after the water has broken and fetal distress.

Can a Baby Survive Cord Prolapse?

cord prolapse

Yes. However, this depends on how quickly the doctors can identify and correct the problem. It is an acute obstetric emergency, meaning that immediate delivery is usually the best course of action. If a doctor can fix the problem immediately, there will likely not be any permanent injury to the baby. The longer it takes to correct the problem, the more likely brain damage, and even death, become. If this happens, the mother may have a valid medical malpractice lawsuit.

Why Is Umbilical Cord Prolapse a Birth Injury?

Sometimes, decisions made by obstetrics and gynecology doctors can increase the chances of cord prolapses. Doctors are expected to fully understand the best current obstetrical practice for each situation. However, even highly experienced doctors can make serious mistakes. These mistakes are as follows.

  • The provider breaks the mother’s water prematurely, before the fetal presenting part has engaged in the pelvis of the mother.
  • The provider uses a balloon catheter as a way to ripen the cervix.
  • Using forceps or a vacuum extraction device
  • Applying an internal scalp electrode to the baby
  • Inserting an intrauterine pressure catheter
  • Amnioinfusion

It is up to doctors and nurses to understand the best course of action if they encounter a prolapsed cord. They should immediately seek to relieve cord compression, restore the baby’s heart rate, and, in some cases, perform a cesarean delivery.

Types of Cord Prolapse

There are three main types of umbilical cord prolapse which we list and describe below.

The umbilical cord drops through the cervix into the vagina after the membranes have ruptured but before the fetal presenting part does in an overt prolapse.

This occurs when the fetal presenting part is at the same location as the umbilical cord, but an exam does not reveal it.

There is a loop of the umbilical cord in an abnormal position between the presenting fetal part and the intact membranes.

How to Diagnose Umbilical Cord Prolapse

Generally, a pelvic exam can reveal umbilical cord prolapse or umbilical cord compression. Some women can feel that the cord has fallen through the open cervix into the vaginal canal. In other cases, doctors might feel the cord during a vaginal examination.

Other diagnoses come from the abnormality of the baby’s heart rate. An unusual heart rate occurs in around 67% of umbilical cord prolapse cases. If mothers are not already at the hospital when they notice these issues, they should call for emergency services. First responders might recommend that the mother gets into a certain position to relieve pressure on the prolapsed cord.

Risk Factors for Umbilical Cord Prolapse

Certain risk factors exist in pregnancy that can increase the likelihood of a prolapsed cord. These risk factors include the following.

  • Pregnancies with more than one baby.
  • The baby has a low birth weight.
  • Breech birth, or breech presentation, in which the unborn baby presents feet-first or buttocks-first.
  • Preterm labor.
  • Preterm membrane rupture, which is when the water breaks before it should. This is also called preterm premature rupture and ruptured membranes.
  • Too much amniotic fluid or polyhydramnios.

Other risk factors involve certain procedures, such as the insertion of a cervical ripening balloon, the rupture of the amniotic sac, or fetal blood sampling.

How Dangerous Is Umbilical Cord Prolapse?

Unfortunately, umbilical cord prolapse is highly dangerous to the health of the baby. The longer it takes to diagnose and treat umbilical cord prolapse, the more likely it is to be fatal. This is why fetal monitoring and doing an ultrasound scan are so important. Delays in diagnosis could result in a lack of blood flow and oxygen to the baby, brain damage, cerebral palsy, and even placental abruption. 

How Is a Prolapsed Cord Managed?

For those who have the umbilical cord past their cervix and in the birth canal, delivery should happen as soon as possible. Many experts recommend that delivery happens no more than 30 minutes after the diagnosis. 

For patients in the first stage or early in the second stage of labor, most professionals recommend a cesarean section immediately. However, some circumstances call for a vaginal delivery, as it may be a faster option. 

While doctors prepare for surgery, it is usually recommended for the mother to be in a knee-chest position. This relieves pressure on the prolapsed cord. The women’s health specialist may also use their hands or fingers to delicately lift the baby’s head or whichever part is causing the cord compression. 

If there must be a delay between diagnosis and delivery, a doctor might try filling the bladder with a saline solution. Bladder filling relieves umbilical cord compression. If manual elevation and filling of the bladder are not possible, the possible perinatal outcomes are grim. Infant outcomes depend almost entirely on how quickly the umbilical cord prolapse and cord compression can be corrected.

Can I Sue for Umbilical Cord Prolapse?

Failing to diagnose or treat umbilical cord prolapse could certainly constitute a medical malpractice claim. It’s important for doctors to engage in the optimal management of umbilical cord prolapse because of the time-sensitive nature of the condition. Failures to act appropriately can lead to serious birth injuries, birth defects, and even death of the baby. If your child suffered a birth injury due to medical negligence, you might have a case. However, you must file your claim before the medical malpractice statute of limitations passes.

Call the Houston Birth Injury Lawyers at Reich & Binstock

At Reich & Binstock, we understand that birth and pregnancy are very stressful times for parents. While it is exciting to bring new life into the world, there are many complications that can arise from simple negligence on the part of the doctor. If you suspect that your child’s birth injury happened because of medical malpractice, you need a qualified birth injury lawyer in Houston. Reich & Binstock is here to offer free consultations to all our clients, no matter how simple or complicated their cases may be. Call today at 713-622-7271 to schedule your free case evaluation with us.

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