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obstetrics_5.3_cord prolapse (risk factors (breech presentation…
obstetrics_5.3_cord prolapse
investigations
CTG
:cry: fetal distress
abnormal fetal heart rate tracing
abnormal fetal scalp pH
history
:cry: fetal distress
physical examination
general
(fetal lie, presentation, engagement) abdominal
(see cord, palpate cord) per vaginal
per vaginal examination
know head position
head station
cervical dilation
delivery
alive
v fully dilated: instrumental delivery
x fully dilated: emergency Caesarian section
call
midwife
neonatologist
senior
move move
x cord manipulation (wrap in warm towel, and prevent spasm)
x cord compressing (put cord away from presenting part)
elevate presenting part (head down, knee-to-chest position)
three types
overt cord prolapse
(ruptured membrane) (cord out of cervix)
umbilical cord compression, umbilical vessel constriction
(:cry: fetal distress: hypoxia, death)
cord presentation
(intact membrane) (cord below presenting part)
occult cord prolapse
(intact membrane) (cord beside presenting part)
risk factors
breech presentation (extended<flexed<footling)
cephalo-pelvic disproportion
prematurity
(polyhydramnios)