Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
CORD PROLAPSECORD PROLAPSE
SALSOSALSO
COURSECOURSE
Cord Prolapse
♦ When part of cord falls in front of presenting
part
♦ Membrane ruptured
♦ Incidence:
0.2-0.4% in vertex
0....
PREDISPOSING FACTORS
♦ Fetal
– Prematurity
– Multiple gestation
– Anencephaly
– Malpresentation
• Breech
• Transverse lie
...
DIAGNOSIS
♦ Appearance of loop of umbilical cord
♦ Pulsation of cord on V/E
♦ Suspect in unexplained fetal distress
– Vari...
MANAGEMENT
♦ Is baby viable?
– IUD - Aim for vaginal delivery
– Alive - aim for most expedient delivery method
• Instrumen...
♦ Relieve cord compression
– Replace cord gently into vagina
– Place hand in vagina, cord cradled in palm
– Tips of finger...
♦ Continuation of relieving of cord
compression during
– Induction of anaesthesia
– Placement of sterile sheet
– LSCS
♦ Re...
Upcoming SlideShare
Loading in …5
×

Cord Prolapse

9,895 views

Published on

SALSO Series - Cord Prolapse

Published in: Health & Medicine, Technology
  • Be the first to comment

Cord Prolapse

  1. 1. CORD PROLAPSECORD PROLAPSE SALSOSALSO COURSECOURSE
  2. 2. Cord Prolapse ♦ When part of cord falls in front of presenting part ♦ Membrane ruptured ♦ Incidence: 0.2-0.4% in vertex 0.5% in frank (extended) breech 4-6% in complete (flexed) breech 15-18% in footling breech
  3. 3. PREDISPOSING FACTORS ♦ Fetal – Prematurity – Multiple gestation – Anencephaly – Malpresentation • Breech • Transverse lie • Oblique ♦ Liquor – Polyhydramnios - especially when PROM ♦ Mother – Multiparity – Contracted pelvis (CPD) – Pelvic tumours ♦ Placenta & cord – P. praevia – Long cord – Rupture of membranes ♦ Iatrogenic prolapse – ARM – Version – Placement of forceps or a scalp electrode* – Obtaining fetal scalp blood for pH*
  4. 4. DIAGNOSIS ♦ Appearance of loop of umbilical cord ♦ Pulsation of cord on V/E ♦ Suspect in unexplained fetal distress – Variable decelerations – Prolonged bradycardia
  5. 5. MANAGEMENT ♦ Is baby viable? – IUD - Aim for vaginal delivery – Alive - aim for most expedient delivery method • Instrumental delivery – if os full and expecting a relatively easy and fast delivery • Otherwise crash Caesarean section
  6. 6. ♦ Relieve cord compression – Replace cord gently into vagina – Place hand in vagina, cord cradled in palm – Tips of fingers elevating presenting part – Mother in trendelenburg or knee-chest position – Fill bladder (16 Foley catheter, 500-800ml of saline)
  7. 7. ♦ Continuation of relieving of cord compression during – Induction of anaesthesia – Placement of sterile sheet – LSCS ♦ Remove hands only when the surgeon tells you!

×