Umbilical cord prolapsed through urethra: An unusual presentation of a vesico-uterine fistula

Umbilical cord prolapse occurs when a loop of cord is present below the presenting part when the amniotic membranes are ruptured. The incidence is 0.2% of total births. The case presented here is unusual because the definition of cord prolapse cannot be applied to it and the lady did not complain of any history of urinary incontinence or hematuria. The presentation of umbilical cord through maternal urethra led to the speculation of an opening between the anterior uterine wall and the bladder. Fetal demise was diagnosed by abdominal ultrasound. At laprotomy, a communication was found between the bladder and the uterus thus letting the cord traverse through the bladder.