I’m a bit confused when studying my obstetrics course (2nd master’s degree in medicine). In the treatment of umbilical cord prolapse in pregnant women, it is stated that you must keep the compression on the umbilical cord as small as possible while awaiting the emergency section. This would be done, among other things, by adopting a certain posture, but also by bladder filling. Well my question, isn’t this a bit paradoxical? Wouldn’t bladder filling actually give you more compression on this umbilical cord prolapse?
Answer
Best,
The bladder will indeed narrow the opening to the vagina somewhat, but this will prevent other parts of the fetus from collapsing and thus reduce the compression. The bladder filling itself also doesn’t give a lot of pressure and wraps around the umbilical cord rather than pinching it. In addition, the fetus, because it remains higher, will hinder the umbilical cord in further sagging. So while the bladder itself provides a little (negligible) compression, it will prevent major compression.
When the bladder is empty (just think of a normal birth), there is more space in the pelvis and the baby can descend more easily. You want to avoid this with umbilical cord prolapse.
Best regards,
Answered by
dr. Jasper Verguts
Gynecology Obstetrics
Old Market 13 3000 Leuven
https://www.kuleuven.be/
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