Spontaneous Umbilical Cord Rupture

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Luckily, a spontaneous ruptured umbilical cord is a rare entity. It is estimated that the incidence is one out of five to ten thousand pregnancies. Spontaneously ruptured umbilical cords can occur during the prenatal course or at the time of labor.

Spontaneous rupture of the cord is associated with umbilical cord cysts which occur randomly.

Half of the fetuses who develop this complication will die.

The umbilical cord consists of two arteries and a vein. The umbilical cord vein to artery rupture is 1:9.

If a diagnosis of an umbilical cord hematoma is made on ultrasound prior to the onset of labor, the fetus should be watched carefully. Your provider may recommend twice weekly nonstress tests along with weekly biophysical profiles. Your provider may also consider performing an amniocentesis to check for fetal lung maturity, and delivering the infant prior to the 39 week gestational age that the American College of Obstetricians and Gynecologists recommend. Under certain circumstances, your provider may elect to deliver the infant even if the lungs are not mature.

There aren’t any predictive values to assess who will have this problem and who won’t. In labor, the condition may manifest itself with fetal intolerance to labor (or what used to be called fetal distress years ago) which would necessitate an emergent delivery of the baby.

Since this condition is quite rare, I inform you of this entity mainly for your edification. I never saw a case of spontaneous rupture in the 32 years that I delivered babies. I would write more about this complication, but the data is skimpy due to the rarity of the condition.
Wishing you a problem free delivery, Pablo.

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