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On occasion, with the rupture of membranes, particularly if the head is not engaged, the umbilical cord may prolapse. A cord prolapse is an obstetrical emergency, as the descending head may block fetal-placental circulation. Once the membranes are ruptured, bacteria may ascend and could lead to amnionitis and fetal infection.
Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labour. [2] Women usually experience a painless gush or a steady leakage of fluid from the vagina. [1] Complications in the baby may include premature birth, cord compression, and infection.
The third membrane is the allantois, and the fourth is the chorion which surrounds the embryo after about a month and eventually fuses with the amnion. [ 6 ] Amniocentesis is a medical procedure where fluid from the sac is sampled during fetal development , between 15 and 20 weeks of pregnancy, to be used in prenatal diagnosis of chromosomal ...
The vessels are hence normally protected by Wharton's jelly, which prevents rupture during pregnancy and labor. [10] In velamentous cord insertion, the vessels of the umbilical cord are improperly inserted in the chorioamniotic membrane, and hence the vessels traverse between the amnion and the chorion towards the placenta.
The fetal membrane is composed of a thick cellular chorion covering a thin amnion composed of dense collagen fibrils. The amnion is in contact with the amniotic fluid and ensures structural integrity of the sac due to its mechanical strength.
The chorion and amnion membranes are labelled in this depiction of a growing fetus in the uterus. The amniotic sac consists of two parts: The outer membrane is the chorion. It is closest to the mother and physically supports the much thinner amnion. The chorion is the last and outermost of the membranes that make up the amniotic sac. [13]
Circumvallate placenta is a rare condition affecting about 1-2% of pregnancies, in which the amnion and chorion fetal membranes essentially "double back" on the fetal side around the edges of the placenta. [1] After delivery, a circumvallate placenta has a thick ring of membranes on its fetal surface. [2]
Umbilical cord prolapse should always be considered a possibility when there is a sudden decrease in fetal heart rate or variable decelerations, particularly after the rupture of membranes. With overt prolapses, the diagnosis can be confirmed if the cord can be felt on vaginal examination.