Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.
| EMS etiologies | Setting: OB/GYN |
A prolapsed umbilical cord is a condition in which the umbilical cord drops through the open cervix into the vagina ahead of the baby during labor. This can happen when the baby is in a breech position or if the amniotic sac ruptures prematurely. A prolapsed cord can potentially compress the umbilical cord, reducing the baby’s oxygen supply and causing distress.
A nuchal cord is a condition in which the umbilical cord wraps around the baby’s neck one or more times during pregnancy or labor. A common occurrence, happening in about 1 in 3 births. In most cases, it does not cause any problems for the baby or the mother. The umbilical cord is designed to handle the baby’s movements during pregnancy. However a tight nuchal cord can cause complications such as decreased oxygen supply to the baby or difficulty during delivery.
Commen presentations include a visible loop of umbilical cord in the vagina and a sudden decrease in fetal heart rate. Very often this is accompanied by an abnormal fetal position difficulty pushing during labor. Fetal distress is noted by decreased movement or meconium-stained amniotic fluid and is a critical issue.
When a cord prolapse is suspected, the mother should immediately be placed in a knee-chest position to relieve pressure on the cord. The mother should be taken to the hospital immediately for further evaluation and management. A cesarean section might be scheduled to deliver the baby as quickly as possible to prevent complications.
If the baby’s head is not yet engaged, the healthcare provider may attempt to manually lift the presenting part off the cord to relieve pressure. If the umbilical cord is wrapped around the baby’s neck, it can often be gently slipped over the baby’s head during delivery.