Is cord prolapse a greater risk in subsequent labors?

[1babysmom]

This is probably a weird question as it just came from one of my strange random thoughts. But basically, I was wondering if cord prolapse is a greater risk (more common) in subsequent babies? The reason I wondered is because of how it's common for subsequent babies to not fully engage until labor (even though many still do beforehand)...so if the membranes rupture before labor (and engagement...in this case), that increases the risk of cord prolapse, right? If that's so, then it would be more of a risk in subsequent babies (in cases where membranes rupture early on) assuming fewer engage before labor, right?

[katelove]

Yep, multiparity is a risk factor for cord prolapse for the reasons you described.

[mwherbs]

more so grand-multiparity because of uterine tone and external muscle tone allowing a baby even late into pregnancy to lay transverse or any odd angle-


uterine tone is usually still good in multips and babies tend to still be funneled fairly tightly by soft tissues- so it isn't as much how far into the pelvis a baby is if the baby's head is at the pelvic brim and there is good uterine tone then fairly low chance of prolapse happening at term/
pre-term birth is the most frequent incidence of cord prolapse- primip or multip- because those babies are small enough even with head deeply enguaged for the cord to flow past and present

[MsBlack]

mwherbs said, final words of her post:

"cord to flow past and present " This confused me a little when I first read it, because the word 'present' has different meanings...so I thought I would add:

...the cord to flow past the baby's head and present first in the pelvis, before baby's head

Hope you don't mind my editing, mwherbs It's just that I spent a minute trying to work out what you meant by 'past and present'.

Anyway--agreed with pp's on this issue. Want to add that I've seen water break prior to labor on several occasions, even with a fair amount of gushing before baby's head finally engaged (happened to me once, too, with my 4th babe), and even in multips x 5 or more. But I've never seen a cord prolapse yet.

So--I'd say cord prolapse may be more statistically likely, but is still far from common. Remember that many babies manage to get that cord wrapped around their neck or other parts, and this is a smart move that can go a long way to prevent cord prolapse!

"Worst case" of ROM I've seen, in terms of concern for prolapse: 2nd baby, ROM 40+ hrs prior to onset of active labor and baby moving down, then back up again throughout that time. So gushing of fluid was fairly heavy for several minutes following ROM, then occurred a few times during the next 40hrs (that is, sometimes just tiny trickles, but sometimes, a goodly flow). Never a hint of cord compression or discomfort in baby. Baby born after 6hrs active labor--with cord wrap x 3 around baby's neck. Nice long cord, too--so the wrap never pulled too tight. Butter birth in the end!

[mwherbs]

yes, I didn't think about how that looks together - thanks for fixing that for me- I was not talking about a span of time --