OpenHealth Q&A

Understanding Cord Prolapse After Birth

Hello everyone, I recently went through a very challenging birthing process and am seeking some insights and information to help me understand what happened. On December 18, during my 38 weeks and 3 days of pregnancy, I arrived at the hospital for an induction of labor (IOL). Initially, I was given three doses of Cytotec every four hours, but it didn’t yield the expected results. The Cook catheter was then attempted for dilation (I was still at 0 cm dilated, 0% effaced, and -3 station) but it was unsuccessful at first. After receiving an epidural, the Cook catheter was successfully placed, and soon after, Pitocin was administered to encourage contractions. Following the removal of the Cook catheter, I was measured at 3 cm dilated, although no further details were noted in my chart. Shortly after this, my membranes were artificially ruptured at 10:10 PM. That’s when a prolapsed cord was identified, leading to an emergency C-section, which was completed by 10:20 PM. Below are the notes from the delivery as well as the results of the cord blood gas analysis. **Delivery Record:** The mother was admitted for labor induction due to antiphospholipid antibody syndrome. At the time of delivery, she received a dose of cefazolin for surgical prophylaxis. After the rupture of the membranes with clear fluid, a cord prolapse was discovered, necessitating an urgent C-section. Upon delivery, the infant showed no grimace response, had poor tone, and exhibited no respiratory effort. After clamping and cutting the cord, the newborn was handed over to the neonatal team, who placed her on a radiant warmer. The infant was equipped with pulse oximetry and EKG leads while positive pressure ventilation started. Thankfully, the heart rate remained above 100 bpm, and within a minute, she was able to breathe on her own, and her color improved. She was then transitioned to CPAP with a maximum FiO2 of 30%. Copious secretions were suctioned, revealing blood-tinged clear fluid, and she was switched to room air by the 2-minute mark of her life. Her oxygen levels were monitored and remained above 93% for the following 15 minutes. Cord blood gas samples were taken. **Resuscitation Summary:** The newborn underwent drying, stimulation, positive pressure ventilation, CPAP, deep suctioning, and blow-by oxygen administration. **Apgar Scores:** - 1 minute: 5 - 5 minutes: 9 **Cord Gas Analysis:** **Arterial Blood Gas:** - pH: 7.047 - pCO2: 83.9 mmHg - pO2: <30.3 mmHg - Base Excess: -10 mmol/L - HCO3: 23.1 mmol/L - O2 Saturation: 14.4% - Oxyhemoglobin: 14.0% **Venous Blood Gas:** - pH: 7.376 - pCO2: 40.8 mmHg - pO2: 33.8 mmHg - Base Excess: -1 mmol/L - HCO3: 23.9 mmol/L - O2 Saturation: 77.5% - %O2Hb: 76.0% Since giving birth, I've been feeling a significant amount of anxiety regarding potential long-term consequences associated with the cord prolapse, particularly concerning hypoxic-ischemic encephalopathy (HIE) or other brain injuries due to lack of oxygen. When I inquired about further testing, such as EEG, CT, or MRI during our hospital stay, I was informed that these were unnecessary, as there were no signs of neurological damage noted. No additional treatments were conducted. Now, at 6.5 weeks old, my baby is exhibiting tremors and some jerky movements, which understandably cause me more distress. I've consulted her pediatrician, who believes these symptoms are likely benign and that she may outgrow them. I would greatly appreciate any guidance from individuals with medical background, to help me interpret this situation and what the gas results imply for her risk of hypoxic injury. It feels as if my concerns were somewhat minimized while in the hospital, and I’m left with ambiguous feelings regarding whether I should be worried. There wasn't a thorough debriefing after the delivery, so I have many unanswered questions. Thank you for your support!

Answers (1)

2/4/2026, 1:30:48 AM

OpenHealth AI

I understand that you're feeling anxious about your recent birthing experience and the health of your newborn after a challenging delivery involving cord prolapse. It’s completely normal to have concerns about potential long-term effects, especially with the complexities noted during the delivery. Let’s break this down to help you understand and address your worries.

Key Points:

1. Cord Prolapse and Immediate Care: Cord prolapse can lead to a decrease in blood flow and oxygen to the baby during labor, but the quick response with an emergency C-section likely minimized potential harm.
2. Apgar Scores and Blood Gas Analysis: Your baby's initial Apgar scores of 5 and then 9 indicate she needed some assistance right after birth but improved well. The blood gas results show signs of significant stress but also reflect that timely medical intervention followed.
3. Current Concerns and Potential Outcomes: The tremors and jerky movements in your baby are understandably concerning, but your pediatrician believes these movements are likely of a benign nature and may resolve as she grows.

Explanation:

• Cord Prolapse Impact: When a cord prolapses, it can compress the cord, leading to potential oxygen deprivation. The rapid actions taken by the healthcare team during the emergency C-section should have limited risks, but monitoring for signs of complications is essential.
• Understanding Blood Gas Results: The arterial blood gas shows a very low pH (indicating acidosis), which points to a stressful situation at birth. However, the rapid improvement in your baby's condition and the follow-up care suggest that the immediate threat has been addressed.
• Long-Term Risks: While there is a concern for conditions like HIE due to oxygen deprivation, the absence of neurological signs at present from your pediatrician is reassuring.

Next Steps:

1. Monitor Development: Keep observing your baby’s growth and development milestones. Make notes of any changes or fluctuations in her movements or behavior to discuss with her healthcare providers.
2. Communicate with Healthcare Providers: Continue to engage with your pediatrician regarding any concerns, especially related to the tremors. If your anxiety persists, don’t hesitate to seek further clarification or a second opinion.
3. Consider Early Intervention Services: If the movements continue or other concerns arise, inquire about early intervention services. These programs can assist in monitoring and providing therapies if needed.
4. Keep a Journal: Document any developments or changes in your baby's behavior or symptoms, which can be helpful during your pediatric visits for more targeted discussions.

Support and Resources:

• Join Support Groups: Find local or online groups for parents who have experienced similar situations. Sharing experiences can be comforting and informative.
• Mental Health Check: Consider talking to a mental health professional if your anxiety about the situation feels overwhelming. It’s vital to take care of your own well-being as you support your baby.

Your concerns are valid, and seeking information and reassurance shows your commitment as a caring parent. With time and continued monitoring, many early concerns can be alleviated. You’re doing a great job caring for your newborn, and I'm here to provide support as needed.