Cord prolapse

Question 1

Definition

Answer 1

Umbilical chord protrudes below the presenting part after the rupture of membranes

Question 2

Risk factors of chord prolapse

Answer 2

1. Abnormal lie or presentation of foetus - transverse/breech
2. Long umbilical chord
3. Multiple pregnancy
4. Acute polyhydromnios

Question 3

Mx of chord prolapse

Answer 3

1. Knee to chest position
2. Elevate the presenting part
3. Fill the bladder with 500 ml of saline to displace the presenting part upwards
4. Hand in vagina and push up presenting part

Question 4

How should the chord be managed?

Answer 4

1. Reduce into the vagina to maintain body temperature

2. Avoid handling to avoid spasms and return it into vagina to limit spasms from exposure

Question 5

Medical Mx

Answer 5

1. Tocolytics - Terbutaline administered to abolish uterine contractions and improve oxygenation of foetus