Cord Prolapse

Question 1

Cord Prolapse

Answer 1

When the umbilical cord descends below the presenting part of the fetus and through the cervix into the vagina, after rupture of the fetal membranes

Question 2

Risk of cord prolapse

Answer 2

Presenting part can compress the cord, resulting in fetal hypoxia

Question 3

Risk factor for cord prolapse

Answer 3

When the fetus is in an abnormal lie after 37 weeks gestation (i.e. unstable, transverse or oblique)

Question 4

Presentation of cord prolapse

Answer 4

Fetal distress on CTG
Seen on vaginal examination
Speculum can confirm diagnosis

Question 5

Management of a cord prolapse

Answer 5

Emergency Caesarean section

Tocolytic medication (e.g. terbutaline) - minimise contractions whilst waiting for delivery by caesarean section

Question 6

Risk of handling the cord

Answer 6

Vasospasm

Question 7

Which position is best for a cord prolapse

Answer 7

Left lateral position (with a pillow under the hip) or the knee-chest position (on all fours), using gravity to draw the fetus away from the pelvis and reduce compression on the cord