Cord prolapse

Question 1

What is an overt cord prolapse?

Answer 1

The cord slip completly out of the cervix and is protruding in the vagina

Question 2

What is an occult cord prolapse?

Answer 2

The cord is compressed alongside the presenting part in the cervix or lower uterine segment

Question 3

What are methods to relieve occult prolapse?

Answer 3

Change in maternal position or gently pushing the fetus upward during a cervical check

Question 4

Whats is the most common first sign of a cord prolapse?

Answer 4

Sudden fetal bradycardia or recurrents varaible taht rapidly get worse]

Question 5

What is a Funic cord presentation?

Answer 5

The cord is in front of the presenting part - needs physician consultation. Funic is a cord presentation that can sometimes be seems in antenatal ultrasound.

Question 6

What are the risk factors for cord prolapse (6)?

Answer 6

1. Prematurity
2. Multifetal gestation
3. Polyhydramnios
4. Fetal malpresentation
5. Multiparity
6. Rupture of membranes with an un-engaged head.

Question 7

What are the steps of management of cord prolapse (11)?

Answer 7

1. Call for help immediately do no leave the women
2. State to everyone in room “I have a cord prolapse”
3. Direct others to page physician Stat and notify operating room
4. Inform laboring person about what is happening and need for c/s
5. Reposition on her side or hands and knees
6. DO NOT attempt to replace cord in uterus
7. With sterile glove get into or on bed insert a hand into the vagina and push up on presenting part, do not stop pressure.
8. Monitor the FHR continuously
9. Administer Oxygen and intravenous fluid bolus.
10. Be prepared to accompany the women while on bed to the OR
11. Operating staff will put sterile drape on you until newborn is safely out of the way.