Prolapse cord occurs when the umbilical cord descends through the vagina before delivery of the baby and can cut off blood flow. It is a medical emergency risked by conditions like ruptured membranes, abnormal fetal positioning high in the pelvis, and others. If a patient reports feeling something coming through her vagina and a cord is visualized, the provider should be notified, sterile gloves used to apply pressure to lift the cord off the baby, and the patient repositioned while giving oxygen and IV fluids in preparation for an emergency c-section if needed to save the baby.

1. Prolapse Cord
Risk Factor--RAPP....
R--ruptured membranes
A--abnormal fetal presentation
P--presenting part high in Pelvis
PTL, SGA, MFP, PPrevia, Hydramnios, Polydramnios
"I feel something coming thru my vagina"
Visualized
FHR = variable or prolong decelerations
Excessive activity followed by cessation of movement = severe hypoxia
Priority:
Call for assistance
Notify Provider
Sterile glove = 2 fingers in vagina & apply pressure
on either side of cord of presenting part lift off cord
Reposition in knee chest, trendelenburg or side lying w/rolled towel under right
or left hip
Apply warm sterile saline soaked towel = prevents drying & maintain blood flow
Continuous FHR monitoring 4 variable decel = asphyxia & hypoxia
O2 8-10 L/min face mask 2 improve fetal oxygenation
Initiate IV access, and administer IV fluid bolus.
Prepare for a cesarean birth if other measures fail.
Inform and educate the client and her partner about the interventions