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cord prolapse (risk factors (breech presentation, cephalo-pelvic…
cord prolapse
risk factors
breech presentation
cephalo-pelvic disproportion
prematurity
(polyhydramnios)
cord
elevate presenting part
head down, knee to chest
x cord manipulation
cord in warm towel (x spasm)
x cord compression
presenting part away from cord
delivery
alive
v fully dilated: instrumental delivery
x fully dilated: emergency Caesarian section
per vaginal examination
elevate presenting part
cervical dilation
head position, head station
call
call senior
call midwife
call neonatologist
three types
cord presentation
(below presenting part) (intact membrane)
overt cord prolapse
(cord prolapse out of cervix) (ruptured membrane :cry:)
occult umbilical prolapse
(x palpable) (beside presenting part) (intact membrane)
physical examination
acute fetal distress
see cord, feel cord
investiagtions
CTG acute fetal distress
history
acute fetal distress
umbilical cord compression
umbilical vessel constriction
acute fetal distress (hypoxia, death:cry:)