(Disclaimer: This article is for scientific purposes only. In order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: In this case, the patient was diagnosed with gestational diabetes mellitus after finding elevated blood glucose in the course of labor and delivery examination, but did not follow the prescribed treatment, which led to gestational diabetes mellitus triggered by amniotic fluid overload. Increased fetal movement and irregular abdominal pain ensued, and she was seen immediately. Due to the excessive amniotic fluid, the fetal membranes ruptured and a large amount of amniotic fluid gushed out, causing the umbilical cord to prolapse, resulting in fetal hypoxia, endangering the lives of the patient and the fetus, and the patient and the fetus were given cesarean section and resuscitation for asphyxia of the newborn, and finally the mother was successfully delivered and the fetus was successfully resuscitated. [Basic information] Female, 32 years old [Type of disease] Gestational diabetes mellitus, preeclampsia, excessive amniotic fluid; fetal umbilical cord prolapse, intrauterine hypoxia [Consultation hospital] Jiangbin Hospital, Guangxi Zhuang Autonomous Region [Time of consultation] August 2021 [Treatment plan] General treatment (oxygen + elevation of the buttocks + upward pushing of the fetal head + return of the umbilical cord) + Surgical treatment (cesarean section) + Pharmacological treatment (injection of Cefuroxime Sodium, Treatment cycle] 6 days of hospitalization [Treatment effect] Successful delivery of the mother and successful rescue of the newborn I. Initial interview The patient reported regular menstruation and 1 abortion. Her last menstrual period was on November 21, 2020, and the ultrasound showed early intrauterine pregnancy for more than 1 month after menopause, and her expected date of delivery was August 28, 2021, and she came to our clinic at 11 weeks of pregnancy. At the 11th week of pregnancy, she arrived at our outpatient clinic to establish her card and undergo regular obstetric examination. At the 16th week of pregnancy, her Down’s syndrome was low-risk, and at the 23rd week of pregnancy, her systematic ultrasound did not show any obvious abnormality; at the 25th week of pregnancy, her OGTT examination revealed elevated blood glucose, and she was diagnosed with gestational diabetes. Subsequently, dietary guidance was given, but blood glucose control was poor, endocrinology consultation was recommended, and the doctor suggested treatment with insulin injections, but the patient refused to take the medication, and still controlled her sugar through diet and exercise. At 36 weeks of gestation, ultrasound showed excessive amniotic fluid with an amniotic fluid index of 27 cm, and on the following day, there were symptoms of increased fetal movement and irregular abdominal pain, so she went to the outpatient clinic, and the fetal monitor showed that the baseline fetal heart rate was fast and about 165 beats/min, and there were irregular contractions, and she was diagnosed as having a preeclampsia at 37+ weeks of gestation in a live fetus with pregnancy and labor, excessive amniotic fluid, and gestational diabetes mellitus, so she was admitted to hospital to wait for the delivery of her baby. After admission, the patient was admitted to the hospital to complete the routine blood tests, blood glucose, electrocardiogram, fetal ultrasound and other tests, and to assess the patient’s birth canal, fetal size, etc. No indication for cesarean section was found, and due to the rapid fetal heart rate, fetal hypoxia could not be ruled out, so she was given the symptomatic treatment of lying on her left side and oxygen inhalation, and then the fetal movement and fetal heart rate returned to normal. At 10:00 a.m., the amount of vaginal fluid was about 400 ml, and the fetal heart rate suddenly dropped to 80 beats per minute. The uterine opening was 5 cm, and the umbilical cord was palpated in the vagina, so it was considered that the umbilical cord prolapsed after the rupture of the fetal membranes. The prolapsed umbilical cord was pressed causing a significant decrease in the fetal heart rate. Immediately, the patient was given elevation of the buttocks, upward pushing of the fetal head and return of the umbilical cord, and the fetal heart rate recovered to 130 beats/minute. We explained the patient’s condition to her and suggested immediate cesarean section because the uterine opening had not yet been opened and it was considered impossible to deliver the baby in a short period of time, and the prolapsed umbilical cord was prone to fetal hypoxia, which would jeopardize the safety of the baby’s life, and the patient agreed to it. The patient agreed. The patient then improved the preoperative preparations and underwent emergency cesarean section immediately, and contacted the neonatologist in the operating room for neonatal resuscitation. After the delivery of the baby, the Apgar score was 3 in 1 minute, and the score was 7 in 5 minutes and 9 in 10 minutes after tracheal intubation, positive pressure oxygenation and cardiac compression were given, and the baby was transferred to the neonatology department for treatment after successful resuscitation. Examination of the placenta was normal, but the umbilical cord was too long and twisted, about 120 cm, and the total amount of amniotic fluid was assessed to be about 2400 ml, which was consistent with the ultrasound findings. Postoperatively, the patient was given injectable cefuroxime sodium to prevent infection, and the drug was discontinued after 24 hours, and at the same time, the patient was given hysteronin injection to promote uterine contraction treatment to reduce postpartum hemorrhage. Third, the effect of treatment The cesarean section procedure was smooth, the patient delivered the fetus, the neonate was successfully resuscitated, and the Apgar score was 9 points after 10 minutes. After medication was administered, the patient had no infection and was no different from a normal woman in labor. At the postoperative checkup 5 days later, the patient recovered well, with normal vital signs, little post-partum discharge, good uterine recovery, and good wound healing; the newborn developed normally without any other diseases, and was discharged from the hospital. The neonate patient and her family expressed satisfaction with the treatment. IV. Precautions We are glad that the patient and the neonate turned out to be safe after the relevant treatment. It is recommended that the patient should rest for 1 month after the operation, avoid heavy physical labor, and ensure sufficient sleep, which is conducive to postoperative recovery; due to the relative weakness of the patient’s body, in order to avoid the occurrence of infections, the abdominal wounds should be carefully cared for to avoid poor wound healing; it is recommended that the patient’s family members care about the patient’s postnatal psychological changes, and the mother is prone to excessive worry about the baby’s condition and postnatal depression; newborn babies can be fed according to the normal infant feeding. V. Personal Insights Umbilical cord prolapse is not common, but once it occurs, it is easy to cause fetal hypoxia, and even lead to fetal death in utero. When the amniotic fluid is too much, the umbilical cord is too long, and the fetal position is abnormal, it is more likely to happen. If the umbilical cord is directly out of the vagina, it is easy to be detected and dealt with in time, but some umbilical cord prolapses are neglected in the vagina. Therefore, if there is an abnormal fetal heartbeat after rupture of the fetal membranes, it is necessary to conduct a vaginal examination in time to determine whether there is umbilical cord prolapse as early as possible. Once umbilical cord prolapse is diagnosed, the pregnancy should be terminated as early as possible, as in this case, and for patients who cannot be delivered vaginally within a short period of time, cesarean section should be performed immediately and neonatal resuscitation should be provided.