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  Prolapsed cord
 
My friend had a prolapsed cord and had to have an emergency caesarian. Can you explain what happened?

Your friend was unlucky as this is a fairly rare occurrence. This usually occurs when the waters of the pregnant woman break and the cord is washed into the birth canal. The pressure of the baby on the cord reduces the flow of blood to the baby and unless the baby is delivered quickly, the baby could die. Occasionally the umbilical cord can be felt or seen at the vagina, or it may be detected during internal examination.

When the baby is head down there is usually not room for the umbilical cord to be swept down the birth canal, but it can still become jammed between the baby and the wall of the birth canal. However if the baby is not quite as snug in the birth canal such as during a breech delivery it is possible for the cord to slip through.

In order to save the baby the delivery must occur as a matter of urgency. If the labour is not well established the doctor may decide to deliver the baby by emergency caesarian. However if the labour has already progressed to second stage then it is too late for a caesarian, and forceps will be used to speed up the delivery. Depending on the position of the cord with relation to the baby, the mother will be positioned so as to attempt to relieve the pressure on the cord during the delivery. The doctor or midwife may also try to lift the baby off the cord as the baby is delivered. Kneeling down with the head on the bed and buttocks in the air is the position usually recommended if a prolapsed cord is detected.

 
   
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