Emergency childbirth rupture. Bleeding after delivery (postpartum hemorrhage) After delivery of the baby, a uterus that is not contracting (atonic uterus), ruptured uterus, remaining parts of placenta or baby or infected remaining parts of placenta or baby can cause severe bleeding. Postpartum bleeding is usually managed preventatively by massaging the lower abdomen (fundal massage), which increases contraction of the uterus and stops bleeding. Additionally, steady traction is applied to the cord to prevent trauma, cord avulsion (tearing of the umbilical cord), uterine inversion, and retained placental products, all of which can increase blood loss and/or the risk of infection. Postpartum hemorrhage is
Umbilical cord prolapse to congenital anomalies or prematurity, however. It is considered an emergency. The first sign of umbilical cord prolapse is usually a sudden decrease in fetal heart rate that is severe and does not immediately resolve. On a fetal heart tracing, this would usually look like moderate to severe variable decelerations. Occasionally, the cord can be seen or felt on vaginal examination, particularly with overt cord prolapse. Risk factors that are associated with umbilical cord prolapse tend to make it difficult for the fetus from appropriately engaging and filling the maternal pelvis or are related to abnormalities of the umbilical cord.