Umbilical Cord Prolapse

Question 1

What is cord prolapse?

Answer 1

Descent of umbilical cord through cervix before presenting part of fetus after membrane rupture

Question 2

What is the effect of cord prolapse?

Answer 2

Fetal hypoxia

• occlusion of umblical cord
• arterial vasospasm on exposure to cold air

Question 3

What are risk factors for cord prolapse?

Answer 3

Breech
Unstable lie
Artificial rupture of membranes
Polyhydramnios
Prematurity

Question 4

How is cord prolapse diagnosed?

Answer 4

Fetal distress on CTG

Vaginal exam

Question 5

How is cord prolapse managed?

Answer 5

Avoid handling cord
Lift fetal presenting part
Left lateral position / knee to chest

Consider tocolysis

Emergency caesarean