Umbilical twine prolapse is uncommon however can occur to anybody throughout any being pregnant, whether or not it’s your first or your fifth. Nonetheless, it solely happens in about 1 to six deliveries out of each 1,000 births. The chances are in your favor. However this emergency means making certain you’ve got a certified and skilled individual serving to together with your supply.2
The umbilical twine is your child’s lifeline. It offers your child vitamins and oxygen whereas nonetheless in your womb. When the umbilical twine prolapses or falls by the cervix into the vagina or beginning canal earlier than the infant, this will trigger the infant’s oxygen and vitamins to lower, which might result in extreme problems comparable to fetal misery, fetal demise, hypoxia, or hypoxic-ischemic encephalopathy, cerebral palsy, mind harm, or stillbirth.1,3
Umbilical twine prolapse occurs after your water breaks, and the umbilical twine slips out of the uterus, by the cervix, and falls into the vagina or beginning canal forward of the infant throughout labor or supply. In a typical supply, your child drops by the dilated cervix earlier than the umbilical twine. If the umbilical twine comes first, it might probably get squished by the stress of your child’s physique. Every contraction of the uterus additionally squeezes the twine. This life-threatening occasion requires quick medical consideration as it might probably create extreme problems for the infant, comparable to compromised blood move and oxygen provide. This complication often happens throughout labor, sometimes proper earlier than or throughout supply.1
We are able to’t predict who could have a prolapsed umbilical twine with their supply, however a number of threat elements can improve the chance of a prolapsed twine, together with:1, 2
- Untimely rupture of membranes: When your water breaks earlier than the infant’s head engages within the beginning canal, the twine could have more room to slide by.
- Malpresentation: If the infant is in a breech place (when every other a part of your child comes out first as an alternative of the buttocks), it might probably improve the probabilities of a prolapse.
- Multiparity: You might be at a barely larger threat if in case you have had a number of pregnancies and deliveries (often 5 or extra).
- Polyhydramnios: When there’s extreme amniotic fluid within the uterus, it might probably improve the probabilities of twine prolapse.
- Preterm labor: Preterm births are extra vulnerable to umbilical twine prolapse.
However umbilical twine prolapse can occur with out these threat elements. Sure situations could improve the probabilities of a prolapse. These different threat elements embody:1,2
- Fetal congenital problems
- Placenta previa
- Irregularly formed umbilical twine (too lengthy, very skinny, and many others.)
- Assisted vaginal supply (utilizing a vacuum or forceps during delivery)4
- Low beginning weight (weighing lower than 5 kilos, 8 ounces, or 2.5 kilograms at beginning)5
- Being pregnant with twins, triplets, or extra (often known as having a a number of being pregnant)
- Irregular twine insertion to the infant (velamentous twine insertion)6
- Excessive fetal station (the fetal station is the infant’s place relative to your pelvis throughout labor)
- Macrosomia (your child is bigger than the common new child).7
- Procedures like amniotomy, when your supplier breaks your water for you or inserts a balloon to ripen your cervix.8
Your supplier and workers are skilled to look at for this throughout labor and supply. They’ll search for frequent indicators and signs of twine prolapse. These could embody:1,2
If umbilical twine prolapse is suspected, your supplier will rapidly relieve the stress on the prolapsed umbilical twine to ensure the infant receives ample oxygen and blood provide. This will contain altering the mom’s place, elevating her hips, or utilizing the Trendelenburg or knee-chest place.10
Your supplier might additionally insert a gloved hand into the vagina to manually transfer the infant’s head off the twine. Supply of the infant should happen as rapidly as attainable to stop any probably life-threatening outcomes. Most often, the supplier will carry out an emergency Cesarean section to expedite the supply and reduce the chance to the infant. A fetal monitor will constantly present the infant’s coronary heart charge, which can assist the supplier resolve what plan to observe.1,2
Sadly, a prolapsed umbilical twine can’t be prevented. It’s additionally troublesome to detect throughout being pregnant due to the frequent actions of the infant and the twine. Among the threat elements for a prolapsed twine could be famous as a part of the mom’s birthing plan in order that the dad and mom and the medical suppliers know the potential for a prolapsed twine. Nevertheless it comes right down to your supplier performing rapidly if a prolapsed umbilical twine happens.
Most infants do survive a prolapsed umbilical twine. In hospitals, the variety of infants that die from a prolapsed umbilical twine is about 3%. Nonetheless, one examine did present the speed as excessive as 7%. When a child is born exterior of a hospital setting, the toddler demise charge is sort of 20 instances larger.1
Umbilical twine prolapse is a uncommon obstetric emergency throughout or simply earlier than supply. Nonetheless, your healthcare workforce will work rapidly to ship your child in the event that they detect an issue. There’s not a lot you are able to do to keep away from one, however understanding the chance elements and what motion must be taken could aid you within the unlikely occasion it occurs throughout childbirth.