The procidence of the cord

Sometimes it happens, fortunately very rarely, that during delivery the umbilical cord does not position itself correctly and that it presents itself before the baby. This is the procidence of the cord, a situation that can prove to be an obstetric emergency.

The explanations of Virginie Christin, Sage liberal woman and attached to the maternity hospital of Bourg-en-Bresse.

What is it about ?

  • When a child is giving birth normally, it is the child who presents and leaves first followed by the umbilical cord and, finally, by the placenta. However, in very rare cases (between 0.3 and 0.6 per 100 deliveries), the cord may appear before the child's head. This is called cord procidence.
  • There are several forms: the procubitus (the cord ahead of the child before the rupture of the water pocket), the procidence (the cord ahead of the child and the water pocket is broken) and finally the laterocidence (the cord lies between the shoulder or the body of the child and the uterine wall).
  • Whatever the form, cord procidence is an obstetric emergency since the cord is compressed between the uterine wall or the cervix and the child's head. This compression causes a less good oxygenation of the child, the blood flowing less well. This results in a slowing of the heart rate and fetal distress that requires emergency intervention.

How is she diagnosed?

  • In the birth room, monitoring can record the heart rate of the fetus. At the slightest sign of a slowing of the baby's heart frequency, the possibility of cord prolapse is considered by the midwife. This possibility can be confirmed by clinical examination or ultrasound examination.
  • Once the diagnosis is made, it is necessary to proceed without delay to the extraction of the child, most often by cesarean section. Exceptionally when the child is too involved in the pool, the medical team will extract it vaginally using instruments like spatulas or forceps.

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