helpful doc

1. Cord prolapse
Dr. Fatma AL-Maqbali

2. Cord prolapse
• Defined as: the umbilical cord comes with or
before the presenting part of the fetus
• very rare < 1% of pregnancies
• More common in PROM

5. Cont. cord prolapse
classifications
• Overt :
- the most common type
- the UC comes before the PP of the fetus
- can be diagnosed clinically
- seen in PROM

7. Cont. cord prolapse
classifications
• occult :
- the UC descent along with the PP of the
fetus
- occur in +- PROM

9. Cont. cord prolapse
risk factors
• Spontaneous factors:
- fetal malpresentation
- polyhydroamnios
- prematurity/ LBW
- mulitible gestations
- PROM (commonest)

10. Cont. cord prolapse
risk factors
• Iatrogenic factors
- ARM
- placement of internal monitor like scalp
electrode
- manual rotation of fetal head

11. Cont. cord prolapse
diagnosis
• Clinical/ overt type
• CTG
• After C.S

13. Cont. cord prolapse
diagnosis (CTG)
• Sudden drop in FHR will show on CTG as
variable decelerations (mild-moderate-
severe- normal)

15. Cont. cord prolapse
Management
• Aim :
to have a viable fetus by fastest and easier way
(C.S)
Will have good results if UCP occurred in
hospital deliveries

16. PROBLEM!
Cord prolapse diagnosed
outside hospital setting
What to do??

17. Cont. cord prolapse
Management / outside hospitalf
• Aim :
to reduce pressure on UC which result in
reducing fetal complications and reaching
hospital with a viable fetus

18. Cont. cord prolapse
Management / outside hospitalf
• Maneuvers :
- Manual elevation of the presenting part
- Repositioning of the mother
- Filling of the urinary bladder using foleys
catheter
- Manual placing the cord back into the uterine
cavity ( sometimes succeed)

19. Cont. cord prolapse
outcomes
If UCP occurred outside hospital>>> 40% fetal
death
In- hospital deliveries >>> 0-3% fetal death

20. Thank u…