Intrapartum Point-of-Care Ultrasound May Prevent Cord Prolapse in Active Labor: Report of a Case

Intrapartum point-of-care ultrasound (POCUS) is increasingly employed to assess fetal head position and labor progression. We describe a case in which intrapartum POCUS enabled the early detection of a compound cord presentation, preventing umbilical cord prolapse.

A 33-year-old primigravida at 39+4 weeks in active labor showed a persistent right occiput posterior position with slow progress despite adequate contractions. After a failed manual rotation attempt, transperineal ultrasound revealed a hypoechoic tubular structure lying between the fetal head and pubic symphysis, consistent with the umbilical cord. These sonographic findings suggested a compound cord presentation. An urgent caesarean section was performed, and a healthy male neonate weighing 3,700 g was delivered with Apgar scores of 9 and 10 and normal cord gases.

Maternal recovery was uneventful. This case highlights the potential of intrapartum POCUS to identify rare, life-threatening conditions such as compound cord presentation, improving decision-making and preventing fetal hypoxia.