Umbilical cord prolapse GTG Flashcards
What is the incidence of cord prolapse?
0.1-0.6%
What is the incidence of cord prolapse in breech?
1%
What is the risk perinatal mortaility?
91/1000
9%
What are risk factors?
- Multip
- BW <2.5kg
- Preterm labour
- Fetal congenital anomalies
- Breech
- Transverse/oblique/unstable
- 2nd twin
- Polyhydramnios
- Unegaged PP
- Low lying placenta
What are procedure related RF for umbilical cord prolapse?
- ARM with high PP
- Vaginal manipulation of fetus with ROM
- ECV
- Internal podalic version
- Stabiling IOL
- Insertion intrauterine pressure transducer
- Large balloon catheter IOL
50% cases after obstetric procedure
How to avoid umbilical cord prolapse?
Transverse/oblique/unstable admit from 37 weeks, must attend if ROM
Noncephalic PPROM - inpatient
No ARM if PP high. If performed with access to theatre
Minimum upward pressure on PP
When to suspect cord prolapse?
Abnormal fetal HR, especially if after ROM
If cord prolapse Dx before fully how to managed
Abnormal CTG: Cat 1 EMCS
Normal CTG: Cat 2 EMCS
How to prevent PP compressing cord
Do not handle cord
Life PP or fill urinary catheter
Knee-chest position or L lateral
Consider tocolysis
If fully, can attempt VD
Can use forceps
