Complicated Deliveries

Question 1

Nuchal cord

Answer 1

If loose slip over the head, can be wrapped more than once. If tight double clamp and cut cord between clamps and unwind from neck. Have mother pant while quickly unwinding cord, prepare for compromised baby

Question 2

Prolapsed cord

Answer 2

Cord gets compressed between fetus and pelvis, insert sterile gloved fingers to raise body part off the cord to restore pulse

Question 3

Breech delivery

Answer 3

Allow body to deliver as much as possible without involvement, limit amount of stimulus, apply supra pubic pressure, allow buttock to deliver, rotate anterior sacrum and hands off. Extract legs once posterior knees visible, deliver 10-15cm of cord, rotate infants hips vertical position, deliver arms and place V finger position in posterior hand to move vaginal wall away from mouth