Seminar

On
Cord prolapse

Submitted to : Submitted by :

Mrs. Felix Joseph

Padmavathi
IV th BSc Nursing
Lecturer
NCON, Raichur
NCON , Raichur
** Introduction **
 Definition

“ Cord Prolapse” is
when the umbilical
cord exits the birth
canal prior to the
baby.
 Incidence
• 1 in 200 pregnancies

• More often with transverse lie than oblique

/ cephalic

• Ranges from 0.14 – 0.62 %

 Etiology

• Fetomaternal factors

• Obstetric interventions
 Etiology >>

• Fetomaternal factors are:

Fetal malpresentation
Prematurity
Multiple gestation
Multiparity
Rupture of membranes
Polyhydraminos
 Etiology >>
• Obstetric interventions :
Artificial rupture
Internal scalp electrode application
intra uterine pressure
Catheter placement
Forceps application
Manual rotation
Amnio infusion
 Risk Factors
• Breech presentation
Risk Factors >>

PROM
(Premature
rupture of the
amniotic sac)
 Risk Factors >>
• Large fetus
Risk factors
• Multiple gestations
• Long cord
• Preterm labor
 Types

• Overt cord prolapse

• Occult cord prolapse
• Funic presentation
 Overt cord prolapse

If the presenting part of the fetus does not

fix the pelvis snugly after membrane
rupture, there is a risk that the umbilical
cord can slip past & present at the cervix
or descend into the vagina
 Occult cord prolapse

• Occur when the cord descends alongside,

but not past, the presenting part. It can
occur with intact or ruptured membranes.
 Funic presentation

• Where the cord can be felt to prolapse

below presenting part before the
membranes have ruptured.
Diagnosis

• History collection
• Physical Examination
• Visual sight
• Ultra sound
• Color Doppler
 Clinical features
• An ill fitting or non-engaged presenting
part.
• Variable fetal heart rate decelerations.
• Bradycardia
• Fetal status activity diminishes and
eventually stops.
 Management

– Immediate vaginal examination to replace the

cord into vagina.
– To relieve cord compression >

a.) Replace the cord gently into the vagina

b.) Elevate the presenting part to prevent
cord compression
Treatment
 Prevention
• Continuous fetal monitoring
 Prevention >>

• No artificial rupturing
 Prevention >>
• Earlier diagnosis
 Diagnosis 1

• Acute pain related to disease

condition
 Diagnosis 2

High risk of injury to fetus related to

cord compression and
uteroplacental insufficiency
 Diagnosis 3

“Knowledge deficit related to life

threatening condition of fetus”
 Diagnosis 4

“Fear and anxiety related to potential

loss of fetus.”
 Diagnosis 5

“Altered family process related to

hospitalization”
 Summarizing ….

Shall I ask questions??

Or
Want to make a discussion?
 Reference
You can download >
Class notes
Presentations,
Pictures
Reference links>>>>

Visit > http://cordprolapse.blogspot.com/

Or mail me > felixwings@gmail.com