BBC Focus Magazine

[nemisis39]

I have a question that might be just me being thick, im not sure. My wife just gave birth last Thursday to the latest addition to our brood, an 18 hour labour her 2nd longest. The doctor checked and her waters were bulging but wouldn’t break. The doctor check on the second visit around 45 minutes later she decided to break her waters, upon doing she shouted cord prolaspe numerous people came rushing in baby was delivered within a 4 minute time span (which the doc elected for as opposed to a caesarean due to the time it would take to prep and get her to the operating theatre approximately 10 minutes.)

Now not knowing exactly what a cord prolaspe was it was a little hairy for a few minutes but everything turned out fine in the end. Now a couple of things came to mind afterwards. He had been 7 weeks earlier in a breech position, which the consultant managed to turn him. All was well had another scan in week 37 then another when she went into labour week 41 (10 days over due date ). Just to make sure he hadn't turned back into a breech position.

At no point during the scans did it show that the cord was in front of the baby blocking his exit so to speak apparently when doing an ultrasound it doesn’t pick up the cord only the baby, my question is why the scan won’t pick it up, also could a piece of scanning equipment be developed to detect were the presence of the cord is

[...]

sorry nem, i aint got a clue.

[nemisis39]

thats ok ... me either

[M Paul Lloyd]

First of all congraulations Nemesis.

As to your question I have been told (Mrs.MPL used to be a midwife) that their are a couple of possibilties, first the umbilcal cord is prone to move around with the baby as the contarctions begin to move it into the birthing position so it might not have shown up on the scan as it wasn't a problem at that time, scondly scans have come a long way in the last thirty years but they don't show everyting and it could concievably have been missed anyway.

A far worse sitaution is when the palcenta is in the same position in which case a cesarean is all but essential in preventing massive haemorage of the womb.

These are good reasons why it is considered better to have a baby in hospital where expert assistance is available rather than at home where you might not be so lucky.

[nemisis39]

Thanks Paul (and Mrs MPL) most informative, as far as im aware though the cord doesn’t show up on an ultrasound so the doctors, midwife’s etc. wouldn’t have known the position in any case which was one of the reasons that made me think of the question in the first place, Mrs Nem is also convinced that the baby knew or sensed the cord was in a bad position hence the reason why he was in the breech position in the first place.
Also so turning the baby to the right position could have contributed to the cord getting in the way, not that any blame can be laid in anyway what so ever to the medical staff at the hospital. In fact if anything we have nothing but admiration for the staff at the hospital and labour ward for their quick thinking and actions.

But still leaves the question about the visibility of the cord or the lack of it in a scan

[M Paul Lloyd]

As far as I know Nemesis the ultrasound they use works best on well defined surfaces like a babies skin but the umbilical is anything but and this may be one of the reasons why it is so difficult to pick up?

[nemisis39]

Is there any type of scanning machine that can pick up the cord, obviously in a safe and controlled way, as it seems to me that it would be a big benefit in helping out with this type of birth and other more dangerous cord complications to boot.
not then could there be a funding available to look into the development of a machine that could detect were the cord is, or is it a case of offsetting the cost of developing something against the percentages of how often it would be use

[M Paul Lloyd]

It would certainly be a good idea Nemesis as my eldest was born with the cord around her neck and it was only the swift action of the highly trained staff on hand that saved her, and I suspect being forewarned of this would have been useful however it is altogether possible that the cord came to be around her neck as she was repositioned inside the womb and under the circumstances which prevail during child birth I can't think of any way of scanning for this safely.
Rather its why we have midwives?

[Shadowwolf]

CT scanners might but I don't think they're the most practical devices in such a situation and given that these things can probably happen so suddenly and at the event, unless there was advanced imaging in real time it would not be noticed any faster than it was.