cord prolapse

Question 1

management of cord prolapse?

Answer 1

1. elevate the presenting part
   - knee/chest position, all 4s
   - head down, left lateral/elevated pelvis
   - manually push the head back
   - fill the bladder to the head back
   - tocolysis (terbutaline or salbutamol to prevent contractions)

Question 2

delivery of fetus in the case of cord prolapse?

Answer 2

1. non-viable: proceed as normal
2. not in Labour/1st stage of labour do cesarean section
3. if in Labour and head below the ischial spine - instrumental delivery but push the cord out of the way