What is Umbilical Cord Prolapse?
Umbilical cord prolapse is a complication that can occur during labor, either during delivery or just prior to delivery. The umbilical cord that has carried nutrients and oxygen to the baby throughout the pregnancy drops through the mother’s dilated cervix and into the vagina before the baby moves into the birth canal. The umbilical cord then becomes trapped between the infant and the cervix. That compresses the umbilical cord, which cuts off blood flow and oxygen to the baby as it is being born.
Umbilical cord prolapse can result in serious birth injury to a child who would otherwise have been born completely healthy. It does not take long for compression of the umbilical cord to result in serious, permanent damage. Fortunately, prolapse of the umbilical cord is not common; the Cleveland Clinic estimates that it takes place in roughly one out of 300 births. The bad news is that when it does happen, it is an emergency. If the doctor or medical professional overseeing the birth does not become aware of the prolapsed cord and act quickly, their inaction may constitute medical malpractice.
Risk Factors and Causes of Umbilical Cord Prolapse
Although umbilical cord prolapse does not occur in every delivery in which risk factors are present, certain conditions should put medical staff on alert that there is a danger of this complication arising. These risk factors include:
- Premature rupture of the membranes (water breaking), especially before 32 weeks of pregnancy
- Preterm labor
- Pregnancy with twins, triplets, or other multiples
- Excessive amniotic fluid (also called polyhydramnios)
- Breech presentation of fetus
- Abnormally long or thin umbilical cord
- Vacuum or forceps delivery
Umbilical cord prolapse can occur even when there are no risk factors, but it is much more likely when one or more of the factors above are present. A prolapsed cord cannot be prevented, but medical providers should be alert to the risk so that they can act quickly if needed.
Diagnosis of Umbilical Cord Prolapse
A fetal Doppler test or ultrasound imaging can show that the placement of the umbilical cord is problematic. A fetal heartbeat of less than 120 beats per minute (bradycardia) may also indicate that there is an issue with the cord. However, often diagnosis of umbilical cord prolapse requires little or no technology: the doctor may see or feel the prolapsed cord during a pelvic exam.
Once an obstetrician is aware that there is or could be a prolapsed cord, the medical team must spring into action. Time is of the essence: most research says that there should be no more than 12 minutes between the first sign of fetal distress and the delivery of the infant by emergency C-section.
Managing a Prolapsed Umbilical Cord
The standard of care for treating a prolapsed umbilical cord is immediate delivery of the baby. Given the risk of lack of oxygen and blood to the infant, attempting to continue with a vaginal delivery can be very dangerous. The doctor may, in some cases, be able to manually relieve compression of the cord until the baby can be delivered by C-section, but the birth must take place as quickly as possible
Complications of Umbilical Cord Prolapse
If a doctor fails to promptly diagnose or treat umbilical cord prolapse, the results can be devastating. Particularly with an overt umbilical cord prolapse, in which the cord presents before the baby, each contraction compresses the cord, decreasing blood and oxygen flow and increasing the risk of birth injury.
Some of the complications of a prolapsed umbilical cord include:
What is most heartbreaking about these serious and permanent conditions is that a few minutes’ inattention or delay on the part of a medical professional could have prevented them altogether. Instead, many families’ lives will be forever changed by loss or the need to provide lifelong care to a seriously injured child. Not only may the child need extensive, costly medical treatment and therapy, but one parent often needs to give up their career in order to care for their disabled child.
Is Failure to Diagnose Umbilical Cord Prolapse Medical Malpractice?
Because umbilical cord prolapse can and should be detected through simple monitoring and pelvic examinations, failure to diagnose and treat the condition in time may constitute medical malpractice. It may be that a doctor ignored risk factors that should have been noted in the patient’s chart. The doctor may also have failed to use a fetal heart rate monitor that would have alerted the medical team to signs of distress. Or, once umbilical cord prolapse was identified, the doctor may have failed to act to deliver the baby as soon as possible.
One thing is certain: if your baby suffered a serious birth injury as a result of an umbilical cord prolapse, you are probably facing a lifetime of economic consequences, not to mention your child’s loss of function and ability. If your baby’s injury was your doctor’s fault, you should not have to bear those consequences by yourself.
You may not know with certainty that your baby’s injury is due to medical malpractice, but if there is a chance that it was, you should explore the possibility. An experienced medical malpractice attorney can help you identify whether you have a claim, and help you pursue it if you do. Unfortunately, if you wait too long to file a medical malpractice claim, you will not be able to seek compensation from your doctor no matter how strong your claim would have otherwise been.
The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact a qualified medical malpractice attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with a competent medical malpractice attorney licensed to practice in your jurisdiction.