Intact newborn survival after spontaneous umbilical cord vascular rupture before labor

Spontaneous umbilical cord vascular rupture is a rare event and historically has led to rapid neonatal demise. This catastrophic event has a small window of opportunity in which intervention may prevent neonatal death.

A 32-year-old multigravid woman's prenatal care was complicated by fetal anomalies, including a two-vessel cord and right pelvic kidney diagnosed during second-trimester ultrasonography. The patient had undergone weekly antenatal testing that was reassuring. She presented to labor and delivery at 36 weeks of gestation with decreased fetal movement and fetal tachycardia and urgently underwent cesarean delivery. On delivery, avulsion of the umbilical cord was noted. The neonate was resuscitated by the neonatal intensive care team and was discharged from the hospital on day of life 14.

A high clinical suspicion of potential prelabor cord avulsion and rapid intervention can lead to the birth of a live newborn.