Pathophysiology
Clinical meaning
Umbilical cord prolapse occurs when the umbilical cord slips ahead of or alongside the fetal presenting part after rupture of membranes. The cord contains two umbilical arteries and one umbilical vein that carry all oxygen and nutrients to the fetus. When the uterus contracts, the presenting part compresses the prolapsed cord against the pelvis, occluding blood flow and oxygen delivery to the fetus. This results in fetal bradycardia, variable decelerations, and if not rapidly corrected, fetal hypoxia, acidosis, and death. The nurse must recognize this emergency, call for help, and assist with emergency interventions as directed.