Cord Prolapse

What is cord prolapse?

An umbilical cord prolapse is an obstetrical emergency that can occur during labour and delivery when the umbilical cord descends into the cervix before or with the baby. In normal births the cord follows the child through the cervix. If the cord drops (prolapses) before the baby, it can become compressed against the child during delivery.

A compressed umbilical cord can partially or fully block off blood flow and oxygen to the baby. This is exceedingly dangerous and requires a rapid response—often delivery by caesarian.

Symptoms of cord prolapse may include:

• Umbilical cord visible through birth canal
• Umbilical felt in birth canal in pelvic examination
• Abnormally low fetal heart rate (bradycardia)
• Decrease in fetal heart rate that is sudden and does not resolve

Diagnosis of cord prolapse:

A baby with a prolapsed umbilical cord requires immediate diagnosis and management. If the cord compression cannot be relieved quickly, the baby will need to be delivered in the fastest and safest manner possible.

Risk factors include:

• Multiple gestations in one pregnancy — twins, triplets, multiples
• Abnormal fetal presentation, particularly breech position
• Premature or artificial rupture of the membranes
• Abnormally long umbilical cord
• Polyhydramnios — excessive amniotic fluid
• Misplacement of internal monitors

Complications:

The umbilical cord is the lifeline between mother and child in utero. If the cord’s function is compromised, it poses serious danger to the survival of the child.

A compressed umbilical cord can asphyxiate the baby and must be treated immediately. If the physician cannot manually reduce the compression, the child will need to be delivered as soon as possible.

The longer the delay, the greater chance that the child will develop brain damage. The more significant the brain damage, the larger the risk of a stillbirth.

Cord prolapse and cerebral palsy:

Cerebral palsy can be the result of perinatal asphyxiation caused by cord prolapse. If the cord compression cuts off the child’s oxygen and blood supply for a long enough duration, the severity of ensuing cerebral palsy symptoms may be profound.

If you experienced a prolapsed umbilical cord in the delivery of your child, and your child has been diagnosed with cerebral palsy, it is possible that you received sub-standard obstetrical care.

There are a number of situations in which cord prolapse can be avoided, such as ignoring or failing to address pregnancy risk factors. For example, cord prolapse is 20 times more likely in the delivery of a child with abnormal positioning, such as breech, oblique or transverse lie, than in a child with cephalic presentation, or situated head-first.

Parents should ask questions about the quality of care they received in their child’s delivery. Often complete information is denied to patients in British Columbia due to Section 51 of the BC Evidence Act. The only way to get the answers you deserve is to hire a lawyer.

The legal team at Campbell, Renaud Trial Lawyers provides free, no-obligation consultations to parents wishing to investigate the circumstances surrounding their child’s brain injury. Please do not hesitate to direct your questions to our offices.