OBG

1. Cord Prolapse
Ms.Sasikalavathi Arunachalam MSc (N) OBG
PRINCIPAL
HARYANA COLLEGE OF NURSING

2. Types
Occult
Prolapse
Cord
presentation
Cord
prolapse

3. Occult Prolapse
The cord is placed
by the side of the
presenting part and
is not felt by the
fingers on internal
examination

4. Cord Presentation
The cord is slipped
down below the
presenting part and is
felt lying in the intact
bag of membranes

5. Cord
Prolapse
•The cord is lying inside
the vagina or outside
the vulva following
rupture of the
membranes.

6. Etiology
Mal
presentation
Contracted
Pelvis
Prematurity
TwinsHydramnios
Placenta
previa-
Marginal
insertion of
the cord,
long cord
Iatrogenic-
ARM,
Version,
Manual
rotation

7. Diagnosis
• Occult Prolapse- difficult to diagnose, detected on
continuous electronic fetal monitoring.
• Cord Presentation- by feeling the pulsation of the
cord through the intact membranes.
• Cord Prolapse- The cord is palpated directly by the
fingers and its pulsation can be felt if the fetus is
alive.

8. Complications
• Fetus-Anoxia
• Maternal-Increased Operative interference

9. Management- Cord Presentation
• No attempt should be made to replace the cord,
• If vaginal delivery is not possible CS.

10. Cord Prolapse Management
Baby alive
If Vaginal delivery
is contraindicated
First Aid
Bladder filling
Lift the
presenting part
Elevated sim
position
Trendelenberg
or knee chest
position
Definitive
management
CS
If Vaginal delivery
possible
Vertex
Forceps
ventouse
Breech
Breech extraction
Baby dead
Conform
Wait for SD
Destructive Operation