Cord Prolapse Flashcards
What is cord prolapse?
Obstetric emergency where the umbilical cord descends through the cervix into the vagina following rupture of fetal membranes
What is the pathophysiology of cord prolapse?
- Membrane rupture
- Non-engagement/partial engagement of presenting part with pelvis
- Cord descent
- Cord compression
- Fetal hypoxia
List the maternal risk factors for cord prolapse
- Premature rupture of membranes
- Multiparity
- Polyhydramnios
List the fetal risk factors for cord prolapse
- Non-cephalic presentation >37 weeks
- Low birth weight and prematurity
- Multiple pregnancies
What are the clinical features of cord prolapse?
- Fetal distress on CTG (abrupt decelerations <60, >60s)
- Palpable/visible umbilical cord
What investigations are used for cord prolapse?
- Cardiotocography (CTG)
- Vaginal examination
- Speculum examination
What is a differential diagnosis for cord prolapse?
Cord presentation (umbilical cord in front of presenting part within amniotic sac)
What is the first step in the management of cord prolapse?
Call for help
What position should the mother be placed in during cord prolapse management?
Knee-chest or Trendelenburg position
What kind of oxygen should be administered to the mother during cord prolapse?
High-flow oxygen via rebreather
Fill in the blank: Tocolytics such as _______ may be considered to minimize contractions while awaiting emergency section.
terbutamine
What are the potential fetal complications of cord prolapse?
- Hypoxic-ischaemic encephalopathy (HIE)
- Intrapartum asphyxia
- Neonatal death
