Treatment and Mortality Rate
Some practitioners will attempt to reduce pressure on the cord and deliver vaginally right away. Frequently the attempt to resolve the prolapsed cord and deliver the baby vaginally fails, and an emergency caesarean section must be performed immediately. While the patient is being prepared for a caesarean, the woman is placed in the Trendelenburg position or the knee-elbow position, and an attendant reaches into the vagina and pushes the presenting part out of the pelvic inlet and back into the pelvis to remove the pressure from the umbilical cord. If attempts to deliver the baby promptly fail, the fetus' oxygen and blood supply are occluded and brain damage or death will occur.
The mortality rate for the fetus is given as 11–17%. This applies to hospital births or very quick transfers in a first world environment. One series is reported where there was no mortality in 24 cases with the novel intervention of infusing 500ml of fluid by catheter into the woman's bladder, in order to displace the presenting part of the fetus upward, and to reduce compression on the prolapsed cord; however a recent trial comparing manual support alone (n=29) versus manual support plus bladder-filling (n=15) showed no added benefit in terms of neonatal outcome.
Read more about this topic: Umbilical Cord Prolapse
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