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Understanding Labor and Delivery Complications -- the Basics

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What Are Common Labor and Delivery Complications? continued...

Premature Rupture of Membranes (PROM)

Normally, the membranes surrounding the baby in the uterus break and release amniotic fluid (known as the "water breaking") either right before or during labor. Premature rupture of membranes means that these membranes have ruptured too early in pregnancy. This exposes the baby to a high risk of infection.

Umbilical Cord Prolapse

The umbilical cord is your baby's lifeline. You pass oxygen and other nutrients from your body to your baby through the umbilical cord and placenta.

Sometimes, before or during labor, the umbilical cord can slip through the cervix after your water breaks, preceding the baby into the birth canal. The cord may even protrude from the vagina -- a dangerous situation because the blood flow through the umbilical cord can become blocked or stopped. You may feel the cord in the birth canal if it prolapses, and may see the cord if it protrudes from your vagina. This is an emergency: Call an ambulance and get to the hospital right away.

Umbilical Cord Compression

Because the fetus moves and kicks inside the uterus, the umbilical cord can wrap and unwrap itself around the baby many times throughout pregnancy. While there are "cord accidents" in which the cord gets twisted around and harms the baby, this is extremely rare and usually can't be prevented.

Sometimes the umbilical cord gets stretched and compressed during labor, leading to a brief decrease in blood flow to the fetus. This can cause sudden, short drops in fetal heart rate, called variable decelerations, which are usually picked up by monitors during labor. Cord compression happens in about one in 10 deliveries. In most cases, these heart rate changes are of no major concern, and the birth proceeds normally. But a C-section may be necessary if the baby's heart rate worsens or the baby shows other signs of distress.

Amniotic Fluid Embolism

This is one of the most serious complications of labor and delivery. Very rarely, a small amount of amniotic fluid -- the fluid that surrounds the fetus in the uterus -- enters the mother's bloodstream, usually during a particularly difficult labor or a C-section. The fluid travels to the woman's lungs and may cause the arteries in the lungs to constrict. For the mother, this constriction can result in a rapid heart rate, irregular heart rhythm, collapse, shock, or even cardiac arrest and death. Widespread blood clotting is a common complication, requiring emergency care.

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