Cord Prolapse

Question 1

What are the risk factors for cord prolapse?

Answer 1

• Malpresentation
• Multiple pregnancy
• Polyhydramnios
• Placenta praevia
• Macrosomia

Question 2

What is the management of cord prolapse?

Answer 2

• Prevent further cord compression = VE
  
  • Reduce pressure on cord - elevate presenting part or fill the bladder
  • Tocolytics
  • Avoid handling the cord (causes cord spasm) - keep cord warm/moist and don’t push back in
• Maternal position
  
  • All fours
  • Knee to chest position - baby will ‘fall’ back into the uterus
  • Left lateral position
  • Ideally have the head slightly declined
• Deliver ASAP
  
  • Either EMCS or expeditated vaginal delivery - whichever will be quicker