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Topic: Cord prolapse

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Amnionic sac

Umbilical cord

Amniotic sac

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Placenta

Adaptation to extrauterine life

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	Umbilical cord - Wikipedia, the free encyclopedia
		In placental mammals, the umbilical cord is a tube that connects a developing embryo or fetus to its placenta.
		Lotus Birth is a practice of leaving the cord uncut after birth so that the baby is left attached to its placenta until the cord naturally separates.
		The term "umbilical cord" or just "umbilical" has also come to be used for other cords with similar functions, such as the hose connecting a surface-supplied diver to his surface supply of air and/or heating, or a space-suited astronaut to his spacecraft.
	en.wikipedia.org /wiki/Umbilical_cord (499 words)

	Cord Accidents at StorkNet's Pregnancy Complications Center
		Cord problems are real problems, especially at term but commonly pathologists believe that a normal cord has enough built-in protection to save itself UNLESS there is some other kind of problem making it harder for the cord to function properly.
		Although true cord accidents do occur in the third trimester, I have no recollection of ever coming to the conclusion of a pure cord accident in the second trimester when the amniotic fluid volume was normal, and the placenta and cord were healthy.
		In fact, the cord is so slippery that when they're trying to encourage the placenta to be born, obstetricians may have to wrap the cord around their hands several times in order to get a good grip on it.
	www.storknet.com /complications/salafia/cord.htm (1843 words)

	Midwifery Today Forums - Cord prolapse (Site not responding. Last check: 2007-11-03)
		I know that one of the mws here had a cord prolapse in second stage with a multip and she made the decision just to have the mother push like h-ll and get the baby out quickly.
		Cord prolapse does not necessarily mean fetal compromise (sometimes the Wharton's jelly will be copious, baby be small, pelvis be roomy, 2nd stage be quick, and all the planets aligned in heaven) but it sure would be considered an emergency occurrence in most mws books.
		The mw that I spoke to who had a prolapsed cord found it on VE and thought she was feeling some swollen cervix over to one side.
	www.midwiferytoday.com /forums/topic.asp?TOPIC_ID=7222 (598 words)

	Skyscape Content: Is it umbilical cord prolapse?
		Fetal factors that predispose to umbilical cord prolapse are largely related to conditions that result in a poor fit between the fetal presenting part and the maternal bony pelvis, which allow the cord to prolapse past the fetal presenting part.
		In a series of 51 cases of acute cord prolapse, combining ritodrine with bladder filling resulted in no cases of perinatal mortality and the majority of newborns had Apgar scores of 7 or higher at 5 minutes with a mean interval of 35 minutes from diagnosis to delivery.
		Of the series of 132 cases of cord prolapse that looked at morbidity and mortality, one of the children identified as acidotic at birth was reported to have had a long-term handicap.
	mediwire.skyscape.com /main/Default.aspx?P=Content&ArticleID=184602 (2186 words)

	Women's Health Advisor 2005.4: Prolapsed Umbilical Cord
		A prolapsed cord occurs when the baby's umbilical cord falls into the birth canal ahead of the baby's head or other parts of the baby's body.
		When the cord is compressed or squeezed (for example, between the baby and the wall of the uterus or vagina), the baby's supply of blood and oxygen is cut off.
		A cord prolapse is not a common occurrence.
	www.med.umich.edu /1libr/wha/wha_proco_crs.htm (700 words)

	TheFetus.net - Umbilical cord prolapse -Val Catanzarite, MD, PhD
		Umbilical cord prolapse can be used synonymously, but usually denotes egress of the cord beyond the cervix, in advance of the leading part of the fetus, usually in the presence of ruptured membranes.
		The rate of umbilical cord prolapse is much lower in the vertex presenting fetus than in the fetus with breech presentation or transverse lie; the overall risk in vertex presentation is quoted at 0.2 to 0.4%, in all breech presentations 3.5%, and in transverse lie or footling breech presentation, approximately 10%.
		It resolved in one case, cord prolapse and fetal death occurred in one case and the remaining patients were delivered by cesarean section for malpresentation.
	www.thefetus.net /page.php?id=185 (1636 words)

	eMedicine - Umbilical Cord Complications : Article by Brian LG Morgan, MD, PhD
		With velamentous insertion, the umbilical cord inserts into the chorion laeve at a point away from the placental edge, and the vessels pass to the placenta across the surface of the membranes between the amnion and the chorion.
		Cord hematoma is a diagnosis of exclusion for fetal death.
		Hemangiomas are tumors of the endothelial cells of the vessels of the umbilical cord.
	www.emedicine.com /med/topic3276.htm (3137 words)

	[No title]
		Cord prolapse is an obstetric emergency as delay in management is associated with significantly increased neonatal morbidity and mortality.
		Umbilical cord prolapse is an infrequent obstetric emergency with a well documented grave fetal prognosis in the literature.
		Prolapse of the umbilical cord: a study of 69 cases.
	www.ispub.com /ostia/index.php?xmlPrinter=true&xmlFilePath=journals/ijpn/vol2n1/cord.xml (2364 words)

	Midwifery Today Forums - Another Prolapsed Cord (Site not responding. Last check: 2007-11-03)
		The boy was not coming as quickly as the doctor (who later told me she was miscarrying at the time of the birth) would have liked so she started with pitocin, had a nurse lay across my belly to push him down and ultimatley broke his water which caused his cord to prolapse.
		I have asked assorted doctors about the cord prolapse causing his delays and all of them have said it would not have been a problem.
		The main worry with cord prolapse is that the oxygen supply is kinked off with the compression of the cord.
	www.midwiferytoday.com /forums/topic.asp?TOPIC_ID=5275 (811 words)

	"But What If.....?"
		When the head is born, if the cord is loose enough, the midwife may loop it over the baby's head, or she might support the baby's head close to your perineum while its body is born, and 'somersault' it so that it is born through the loop of cord.
		If the cord is too tight for this then she might clamp and cut the cord as soon as the head is born - for example, see Nicola's story, Suzanne's, or Doris's story.
		Cord prolapse is an example a risk affecting a relatively small proportion of births, which skews the safety statistics overall.
	www.homebirth.org.uk /whatif.htm (3932 words)

	Clinical Practice Guidelines : Cord Prolapse
		Cord Prolapse: Where the umbilical cord lies in front of or beside the presenting part in the presence of ruptured membranes.
		Cord Presentation: Where the umbilical cord lies in front of the presenting part and the membranes are intact.
		Diagnosis of cord prolapse is made by visual inspection or palpation on vaginal examination where the umbilical cord is felt below or beside the presenting part.
	www.rwh.org.au /rwhcpg/maternity.cfm?doc_id=5653 (313 words)

	Four Complications Involving the Umbilical Cord
		The truth is, most babies who are born with the cord around their neck require only an extra moment at birth for the practitioner to unwind it, and then go on to be perfectly healthy.
		In the event of a prolapsed cord, the baby will be delivered by cesarean section to prevent further compression of the cord during childbirth.
		In extremely rare situations, a knot found in the cord of a baby who was stillborn will be presumed responsible for the baby's demise, as it may have tightened enough to stop blood flow through the umbilical cord.
	www.drspock.com /article/0,1510,5332,00.html (591 words)

	Pregnancy cord prolapse pregnant (Site not responding. Last check: 2007-11-03)
		The cord prolapse is a dreaded complication at a premature bladder jump.
		The cord is drawn in front of the head of the child by the undertow effect of the fetus water flowing out and the gravity to below.
		The cord is the transport route between the maternal and childlike organism.
	www.health-illness.com /pregnancy/cord-prolapse.html (351 words)

	Quick Reference: Umbilical Cord Abnormalities
		The umbilical cord is a narrow, tube-like structure that connects the developing baby (also referred to, in medical terms, as the fetus) to the placenta.
		Prolapse is more common when the umbilical cord is too long, when there is too much amniotic fluid or when the membranes are ruptured artificially to start or speed up labor.
		This complication occurs when the umbilical cord inserts abnormally in the fetal membranes of the placenta, instead of in the center of the placenta (which may be abnormally shaped or positioned).
	www.marchofdimes.com /professionals/14332_4546.asp (1651 words)

	The Umbilical Cord
		The umbilical cord is the lifeline between the fetus and placenta.
		The converse is also true—less intrauterine movement leads to shorter umbilical cords (as attested to by animal experiments where induced fetal muscle paralysis led to shortened umbilical cord length).
		Cord twisting can be seen as early as the 6th week and is well established by the 9th week of development.
	info.med.yale.edu /obgyn/kliman/placenta/articles/EOR_UC/Umbilical_Cord.html (2597 words)

	Umbilical Cord Prolapse
		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.
		Umbilical cord prolapse is a complication that occurs prior to or during delivery of the baby.
	www.clevelandclinic.org /health/health-info/docs/3800/3870.asp?index=12345 (467 words)

	Cord Prolapse - allnurses.com Nursing for Nurses
		Wrapping the cord in sterile gauze is of no use, as the vagina is not a sterile environment, and since membranes are ruptured, there is already the possibility that bacteria and other micro-organisms have begun to ascend the reproductive tract.
		If the cord is trapped inside the vagina, I believe you would insert a sterile gloved hand to put counter-pressure against the fetal presenting part, in an effort to "lift" it off the cord, again relieving pressure on the cord and re-establishing blood flow to the baby.
		For regards to the cord hanging out of the vagina I was always told to try and AVOID touching the cord as that could lead to vasospasm and cause worsening complications, and use a gloved hand to help hold the head off the cervix w/ the pt either in trendelenberg or hand/knee position.
	allnurses.com /forums/f35/cord-prolapse-54816.html (1036 words)

	Understanding Stillbirth (Site not responding. Last check: 2007-11-03)
		The main causes of still birth are placental abruption, placental flailure, cord prolapse and the cord wrapping around the baby in utero.
		Cord prolapse is when, during labor, the umbilical cord comes out ahead of the baby and when the baby drops down toward the birth canal, it will pinch the cord shut, thus stopping oxygen flow to othe fetus, thus resulting in demise.
		And in rare instances the cord can be pinched or even knotted (mostly with unordinarily long cords) cutting or limiting oxygen and nutrients to the baby.
	www.suite101.com /article.cfm/pregnancy_after_miscarriage/84741 (409 words)

	Prolapsed Cord - Patient UK
		Prolapse exposes cord to intermittent compression between the baby and the mother compromising the fetal circulation.
		Exposure of umbilical cord to air in overt prolapse causes irritation and cooling producing vasospasm of the cord vessels.
		Incidence of occult prolapse unknown but 50% of monitored labours show fetal heart rate changes suggesting umbilical cord compression, which is usually transitory and relieved by changing mother's position.
	www.patient.co.uk /showdoc/40000243 (561 words)

	Perinatal.nhs.uk
		It is important to prevent compression of the cord by the fetal head during contractions.
		These studies were however uncontrolled, and we do not know how many instances of cord prolapse occur overall, and how many of these result in perinatal death with conventional management.
		The apparent low number of deaths (n=13) associated with cord prolapse in the West Midlands over the last 5 years would suggest that conventional methods of management are also effective.
	www.perinatal.nhs.uk /reviews/oe/oe_cord_prolaspe.htm (310 words)

	ANB & T et al vs Cook County - obstetrical malpractice, umbilical cord prolapse
		This is because the umbilical cord and the extremities are hanging down toward the birth canal.
		This is because the function of the umbilical cord delivering oxygen to the fetus is likely to be compromised during cord prolapse so that blood and oxygen are cut off.
		It is apparent from G's brain injuries that the cord prolapse, cord compromise, and resulting asphyxia went on for a long time, at least 8 to 10 minutes or longer.
	www.malpracticeweb.com /cch_anb_es.htm (2884 words)

	UpToDate: Patient Information Site
		It is life threatening to the fetus since blood flow through the umbilical vessels is usually compromised from compression of the cord between the fetus and the uterus, cervix, or pelvic inlet.
		Overt prolapse, which is the most common, refers to protrusion of the cord in advance of the fetal presenting part, often through the cervical os and into or beyond the vagina.
		The evidence for causation of cord prolapse with obstetrical interventions is conflicting and it is often difficult to determine whether UCP would have occurred spontaneously if the intervention had not been performed [11].
	patients.uptodate.com /print.asp?print=true&file=labordel/2191 (824 words)

	Frquently Asked Questions
		With a cord prolapse there are also blood vessels (although protected by Wharton's jelly) in front of the cervix.
		Cord prolapse is of a free floating umbilical cord which happens to be presenting in front of a cervix which dilates, allowing the cord to enter the canal and then
		A velamentous cord may have a more delicate origin and be at risk of torsion and obstruction.
	www.vasaprevia.org /faqs/faqs.htm (4332 words)

	MotheringDotCommune Forums - Self-diagnosing Cord Prolapse
		As far as the water breaking and cord prolapse, a lot depends on when it breaks in labor.
		Some moms can feel the cord in the vagina, but it doesn't have to be that low to cause a problem.
		There's such a thing as a hidden prolapse, though, where the cord is between the head and the pelvis.
	www.mothering.com /discussions/printthread.php?t=240408 (1190 words)

	Medical References: Umbilical Cord Abnormalities
		Sometimes the cord is too long, too short, connects improperly to the placenta or becomes knotted or compressed.
		Cord abnormalities can lead to problems during pregnancy or during labor and delivery.
		This is sometimes referred to as a “cord accident.” Sometimes babies with tightly coiled cords begin to move less.
	www.marchofdimes.com /professionals/681_4546.asp (1649 words)

	HON Mother & Child Glossary, Prolapsed Umbilical Cord (Site not responding. Last check: 2007-11-03)
		The problem becomes apparent when the foetal heart monitor, which is usually attached to the mother's abdomen, shows that the baby's heart rate has decreased.
		To further help take the pressure off the cord, the nurse or doctor will keep a hand in the mother's vagina until the baby is delivered the fastest way possible, usually by emergency caesarean section.
		If the prolapsed cord causes the baby's heartbeat to slow, a caesarean section will probably be necessary.
	hon.ch /Dossier/MotherChild/labor_complications/birth_cordprolapse.html (485 words)

	MCPC - Prolapsed cord
		The umbilical cord lies in the birth canal below the fetal presenting part.
		The umbilical cord is visible at the vagina following rupture of the membranes.
		If the cord is pulsating, the fetus is alive.
	www.who.int /reproductive-health/impac/Symptoms/Prolapsed_cord_S97_S98.html (271 words)

	Umbilical Cord Prolapse And Emergency Caesarean Section - A Review Of 25 Cases (Site not responding. Last check: 2007-11-03)
		Runnebaum IB, Katz M. Intrauterine resuscitation by rapid urinary bladder instillation in a case of occult prolapse of an excessively long umbilical cord.
		Yla-Outinen A, Keinonen PK, Tuimala R. Predisposing and risk factors of umbilical cord prolapse.
		Koonings PP, Paul RH, Campbell K. Umbilical cord prolapse.
	ispub.com /ostia/index.php?xmlFilePath=journals/ijgo/vol1n1/cord.xml (2388 words)

	Rupture of Membranes Causes Cord Prolapse - FROM RONNIE Falcão's MIDWIFE ARCHIVES (Site not responding. Last check: 2007-11-03)
		If you could feel the cord below the head and you needed to break the waters, there are things you could do to try to move the cord.
		The reason the cord got below the head in the first place was that it was a long cord, and cords sink in fluid.
		Once the cord is below the head, you can apply gentle pressure to move the baby into the pelvis and keep it there to prevent the cord from sinking again past the head when the mom gets upright.
	www.gentlebirth.org /Midwife/cordprol.html (696 words)

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