Umbilical cord prolapse is a rare but life-threatening obstetric emergency. It requires immediate, coordinated action to prevent fetal hypoxia and maternal complications.
At Maternal 911 Education Systems, we stress that early recognition and readiness are essential for improving both maternal and neonatal outcomes.
What Is Umbilical Cord Prolapse?
Umbilical cord prolapse occurs when the cord slips through the cervix before the presenting fetal part. As a result, the cord becomes compressed, cutting off oxygen to the fetus. This can lead to brain injury or stillbirth within minutes if not managed promptly.
Although it occurs in only 0.1–0.6% of births, the consequences are severe. Therefore, every obstetric team must stay alert, prepared, and well-trained.
Why It Matters for Maternal Safety
While the fetus faces the most immediate risk, maternal safety can also be compromised. A delayed or disorganized response increases the chances of:
- Hemorrhage during emergency cesarean delivery
- Anesthesia complications
- Postpartum infection
- Long-term psychological trauma
Thus, maternal and fetal safety are deeply connected. Effective teamwork ensures both survive and recover well.
Key Risk Factors to Watch
Recognizing high-risk conditions can help prevent delays in care. Common risk factors for umbilical cord prolapse include:
- Malpresentation (breech, transverse lie)
- Polyhydramnios
- Preterm labor or premature membrane rupture
- Unengaged presenting part
- Multiple gestation
- Long umbilical cord
However, umbilical cord prolapse can occur unexpectedly, which is why continuous monitoring and situational awareness are crucial throughout labor.
Recognizing the Warning Signs
Early recognition is the difference between life and loss. Key signs include:
- Sudden fetal bradycardia or variable decelerations after membrane rupture
- Palpable or visible umbilical cord during examination
- A patient reporting a “cord-like” feeling or visible tissue at the vaginal opening
When these symptoms appear, clinicians must act instantly. At Maternal 911 Education Systems, we teach that hesitation costs time — and time costs lives.
Immediate Response: The Maternal 911 Protocol
When umbilical cord prolapse is suspected or confirmed, follow these steps immediately:
- Call for Help – Activate your obstetric emergency response team.
- Relieve Cord Compression – Elevate the presenting part manually with a gloved hand.
- Position the Patient – Use the Trendelenburg or knee-chest position to reduce pressure.
- Stop Oxytocin and Give Oxygen – Stabilize the fetal environment quickly.
- Prepare for Emergency Cesarean – Aim for decision-to-incision within 10 minutes.
Every second matters. These interventions can prevent permanent fetal damage and maternal distress.
How Simulation Improves Response Time
Simulation-based training is proven to enhance performance in obstetric emergencies. It strengthens teamwork, reduces hesitation, and improves outcomes. At Maternal 911 Education Systems, we emphasize:
- Early recognition of rare emergencies like cord prolapse
- Clear communication and defined team roles
- Practiced emergency cesarean workflows
- Psychological safety under stress
Because when care teams train together, they act faster, safer, and more effectively during real crises.
Conclusion
Umbilical cord prolapse is unpredictable but manageable with the right preparation. Early recognition, swift action, and team coordination are vital to protecting both mother and baby.
At Maternal 911 Education Systems, our mission is to ensure every healthcare team can act decisively when seconds count. Through simulation, standardized protocols, and education, we turn readiness into life-saving action.
Educational use only — not a substitute for clinical judgment or local protocols.
Click here to contact us with any questions.
References
- American College of Obstetricians and Gynecologists (ACOG). (2015). Umbilical Cord Prolapse. Practice Bulletin No. 164.
- Beckmann CRB, et al. (2022). Obstetrics and Gynecology, 9th ed.
- Clark SL, et al. (2014). Strategies for reducing maternal mortality. Obstetrics & Gynecology, 123(5), 1053–1060.
- Royal College of Obstetricians and Gynaecologists. (2014). Umbilical Cord Prolapse: Green-top Guideline No. 50.
Maternal 911 Education Systems, LLC is a leader in emergency obstetrics and team training, improving outcomes through education and evidence-based practice. Maternal 911 Education Systems, LLC is led by a team of experts in emergency obstetrics and maternal safety, dedicated to improving outcomes through evidence-based, team-centered education. Passionate about maternal health education, Maternal 911 advocates for evidence-based practices and interdisciplinary team training. Their mission is to reduce pregnancy risks through education and emergency training. Learn more at maternal911.com.
Educational use only – not a substitute for clinical judgment or local protocols.
Click here to contact us with any questions.
