Umbilical Cord Prolapse and Management Upon Medical Personnel Skills – Case Report

Abstract

Umbilical cord prolapse is obstetric emergency that may have significant neonatal morbidity and mortality if not prompt professional management does not take place. Umbilical cord prolapse is the descended umbilical cord via collum uteri with proceeding presenting part after ruptured of membranes of the amniotic fluid. Case Report A 31 years old pregnant woman, comes to maternity service after her waters were broken (ruptured membranes of amniotic fluid), spontaneously at home. It was her second pregnancy; her first pregnancy was vaginal delivery 3 years ago. Actual pregnancy according to her last menstrual period was term pregnancy; she stated that was followed up during pregnancy by her obstetrician. Within very few minutes, patient was seen by admission midwife, where vaginal examination was performed and umbilical cord prolapsed was identified. The fetal heart rate was listened by Pinard horn obstetrical stethoscope and bradyarrythmia was present. The on duty obstetrician was called, while patient was kept on obstetrical lithotomy position by midwife.  Bimanual pelvic examination was performed by obstetrician on duty, the prolapsed of umbilical cord was confirmed and bradyarrythmia of fetal heart was present. At this time, patient was taken to operating room, and electronic fetal monitoring was performed, where fetal bradyarrythmia 90 FHR/min and immediate Cesarean section delivery was performed, baby did cry immediately after delivery, Apgar score 8/9 referred neonatologist assessment. Conclusion , umbilical cord prolapse is a life threatening event for the fetus and requires immediate intervention. Medical personnel should be well trained to address such emergency proper and professional management. Keywords: Umbilical cord prolapse, obstetrical emergency, mortality, morbidity, fetus DOI: 10.7176/ALST/80-04 Publication date: April 30 th 2020