CORD PROLAPSE

Question 1

WHAT IS CORD PROLAPSE ?

Answer 1

CORD PRESENTING IN FRONT OF PRESENTING PART- FOLLOWING RUPTURES OF MEMBRANES.

Question 2

INCIDENCE OF CORD PROLAPSE RANGES ? IS THIS FOR ALL BIRTHS?

Answer 2

0.1-0.6% OF ALL BIRTHS

Question 3

IN THE CASE OF BREECH PRESENTATION, THE INCIDENCE OF CORD PROLAPSE IS???

Answer 3

1%

Question 4

IS CORD PROLAPSE LIFE-THREATENING FOR THE BABY?

Answer 4

YES

Question 5

CAN WE SEE THE CORD IN A CORD PROLAPSE?

Answer 5

CAN BE VISIBLE AT THE VULVA OR MAY HAVE PROLAPSED OUT OF THE VAGINA.

MAY ALSO BE DETECTABLE ON EXAMINATION OF THE VAGINA.

Question 6

HOW DO WE RELIEVE CORD COMPRESSION 1/4

Answer 6

1. MANUALLY ELEVATE THE PRESENTING PART (WITH GLOVED FINGERS).

Question 7

HOW DO WE RELIEVE CORD COMPRESSION? MANUAL ELEVATION OF PRESENTING PART RATIONALE:

Answer 7

RELIEVES COMPRESSION PARTICULARLY DURING CONTRACTIONS

Question 8

HOW DO WE RELIEVE CORD COMPRESSION 2/4

Answer 8

IF THE COR HAS PROLAPSED OUT OF THE VAGINA, ATTEMPT TO GENTLY REPLACE IIT BACK IN TO THE VAGINA USING A DRY PAD WITH MINIMAL HANDLING.

Question 9

HOW DO WE RELIEVE CORD COMPRESSION.
RATIONALE BEHIND GENTLY REPLACING THE PROLAPSE (OUT OF VAGINA) WITH A DRY PAD 2/4

Answer 9

HANDING MAY CAUSE VASOSPASMS. NO EVIDENCE TO SUPPORT USING GAUZE SOAKED IN WARM SALINE.

Question 10

HOW DO WE RELIEVE CORD COMPRESSION 3/4

Answer 10

POSITION THE WOMAN

Question 11

HOW DO WE RELIEVE CORD COMPRESSION 3/4

POSITION OF WOMEN

Answer 11

Exaggerated Sim’s position: woman into left lateral position with head down and pillow placed under left hip
OR knee chest position

Question 12

HOW DO WE RELIEVE CORD COMPRESSION 3/4

POSITION RATIONALE

Answer 12

MAINTAIN POSITION IN WHICH CORD COMPRESSION IS RELIEVED UNTIL THE BABY IS BORN

Question 13

HOW DO WE RELIEVE CORD COMPRESSION 4/4

Answer 13

TRANSFER IMMEDIATELY

Question 14

HOW DO WE RELIEVE CORD COMPRESSION 4/4

WHY TRANSFER IMMEDIATELY ?

Answer 14

DELIVERY OF THE BABY IS NEED ASAP

Question 15

BLADDER-FILLING

Answer 15

If the decision-to-birth interval is likely to be prolonged – particularly if it involves ambulance transfer – elevation of the presenting part through bladder-filling, may be considered ONLY DO IF TRAINED TO – ALL CMW CARRY CATHETERS

Question 16

RATIONALE BEHIND BLADDER FILLING

Answer 16

elevates the presenting part off the compressed cord for an extended time, allowing for time to transfer and freeing up a practitioner

Question 17

BLADDER FILLING PROCEDURE

Answer 17

Insert Foley catheter into the bladder

Fill bladder via catheter with 500ml 0.9% sodium chloride, using an IV infusion set (squeeze fluid in) and clamp once 500ml has been instilled

Leave the bag of fluid attached for transfer to hospital or labour ward:

Rationale: this will remind staff to empty the bladder when the woman arrives in hospital/theatre

It is essential that the bladder is emptied before any method of delivery is attempted- detach the giving set from the catheter and let the fluid drain out

If catheter is to remain in situ for a c/s, attach a catheter bag

However, catheter should be removed if vaginal birth anticipated

Rationale: to prevent trauma