Cord prolapse Flashcards
What is a cord prolapse?
when the umbilical cord descends below the presenting part of the foetus and through the cervix into the vagina, after rupture of the foetal membranes.
What is the significant danger in a cord prolapse?
There is a significant danger of the presenting part compressing the cord, resulting in foetal hypoxia.
What is most significant risk for a cord prolapse?
when the fetus is in an abnormal lie after 37 weeks gestation (i.e. unstable, transverse or oblique).
Being in an abnormal lie provides space for the cord to prolapse below the presenting part.
How is cord prolapse diagnosed?
Umbilical cord prolapse should be suspected where there are signs of foetal distress on the CTG.
A prolapsed umbilical cord can be diagnosed by vaginal examination.
Speculum examination can be used to confirm the diagnosis.
Management for cord prolapse?
Emergency caesarean section is indicated where cord prolapse occurs.
Why is normal vaginal delivery not carried out in cord prolapse?
A normal vaginal delivery has a high risk of cord compression and significant hypoxia to the baby.
Pushing the cord back in is not recommended.
The woman can lie in the left lateral position (with a pillow under the hip) or the knee-chest position (on all fours), using gravity to draw the foetus away from the pelvis and reduce compression on the cord. true/false?
true
What medication can be used to minimise contractions whilst waiting for delivery by caesarean section?
Tocolytic medication (e.g. terbutaline)
