Umbilical cord these branches joins with the hepatic portal vein (connecting to its left branch), which carries blood into the liver. The second branch (known as the ductus venosus) bypasses the liver and flows into the inferior vena cava, which carries blood towards the heart. The two umbilical arteries branch from the internal iliac arteries and pass on either side of the urinary bladder into the umbilical cord, completing the circuit back to the placenta. In absence of external interventions, the umbilical cord occludes physiologically shortly after birth, explained both by a swelling and collapse of Wharton's jelly in response to a
Umbilical cord prolapse should be suspected if there is a sudden decrease in the babies heart rate during labor. Seeing or feeling the cord confirms the diagnosis. Management focuses on quick delivery, usually by cesarean section. Filling the bladder or pushing up the baby by hand is recommended until this can take place. The knee-chest position, or if this is not possible Trendelenburg position may be used. With appropriate management, the majority of cases have good outcomes. Umbilical cord prolapse occurs in about 1 in 500 pregnancies. The risk of death of the baby is about 10%. Much of this risk is due