Cord prolapse Flashcards
1
Q
what is it
A
Descent of the cord through the cervix below the presenting part after ROM
2
Q
Why is it an emergency
A
Emergency as cord compression and vasospasm from exposure of the cord causes fetal asphyxia
3
Q
what are risk factors for cord prolapse
A
- 2nd twin
- Footling breach
- Prematurity
- Polyhydramnios
- Unengaged head
- Transverse/unstable lie
- Male
4
Q
When should CS definitely be the mode of delivery?
A
if cord presentation is noted prior to membrane rupture
5
Q
How does cord prolapse present?
A
- obvious if cord at introitus
- fetal bradycardia
- variable fetal heart decelerations
6
Q
How should cord prolapse be managed
A
- keep cord in vagina
- minimal handling of cord to prevent spasms
- displace presenting part by putting hand in vagina and push it back up during contractions
- knee to chest position so bottom higher than head
- tocolysis to reduce contractions and help bradycardia (terbutaline SC)
- DELIVER FETUS ASAP
7
Q
What is the mode of delivery for cord prolapse?
A
LSCS or instrumental ASAP if fully dilated
if fully dilated and presenting part is low in pelvis - ventouse/forceps if leading to <15min delivery
8
Q
How is hypoxic brain injury that may have resulted from delivery excluded?
A
paired cord blood samples for pH and base excess
