GROUP 1: Camposano, Cielo, Edem, Ibalin, Rodriguez

Each group will make a case analysis for this patient. and after case presentation Mrs
Dizon 40 y/o, married, live at Putiao, Sorsogon G2P3 , AOG 39 weeks was admitted at
9am today due to cord protrudes from vagina and palpation of cord in the vaginal canal
/cervix during IE , IE showed at 8cm dilated cervix +fetal movement . V/S - BP-
110/90mmhg, PR- 90bpm , RR, 20 CPM, BT- 37.5

Question: Kindly analyze the situation of your patient. what indication and obstetrical
health problem that arises to your patient. Relate the situation on complication of the
pregnancy. Make a Midwife care that is included in your presentation

PATIENT’S PROFILE
Name: Mrs. Dizon
Age: 40 years old
Status: Married
Address: Putiao, Sorsogon
G2P3
AOG: 39 weeks

ASSESSMENT
SUBJECTIVE
Chief complaints: cord protrudes from vagina and palpation of cord in the
vaginal canal /cervix during IE
OBJECTIVE
Vital signs:
BP- 110/90 mmhg
PR- 90 bpm
RR- 20 cpm
BT- 37.5
IE: 8cm dilated cervix +fetal movement, +present of cord

DIAGNOSIS
 Cord Prolapse: a complication when the umbilical cord falls or is washed
through the cervix into the vagina.
 Obstetrical history of abortion, and age older 35 years old mother is candidate
for high risk pregnancy and labor.
 Prolapsed umbilical cord may lead to fetal distress (immediate management
and care are needed).
 Furthermore, patient must undergo laboratory, ultrasound examination, and
continuous diagnostic tests (vital signs) for maternal and fetal monitoring.

DANGER SIGNS
 PROM
 Presenting parts has not yet engaged
 Fetal distress
 Protuding cord from vagina

LABORATORY AND DIAGNOSTIC TESTS

 CBC
 Urinalysis
 Fetal movement counting, nonstress test, biophysical profile, doppler flow
studies, and ultrasound examination.
 Continues taking of vital signs: BP, pulse rate, respiration rate, and body
temprerature

CORD PROLAPSE
GROUP 1: Camposano, Cielo, Edem, Ibalin, Rodriguez

MEDICATIONS
 Oxygen therapy
 IVF therapy
 Saline solution for amnioinfusion

INTERVENTION
 Administer IVF, usually Ringer Lactate.
 Provide oxygen therapy to supply both mother and fetus.
 Prevention: place woman in bed rest after membranes have ruptured.
 Reduce pressure on the cord
 Place in Knee-chest or trendelenburg position, or place a folded towel
under the hips.
 Put on sterile gloves and insert two fingerss into the vagina then, push
presenting part upward.
 If cord is exposed to air, cover it with saline moistened sterile compress.
 Never replace the cord back into the vagina as this will result cord kinking.
 Administer amnioinfusion to prevent cord compression.
 Monitor fetal condition and the patient's vital signs continuously.
 Request for laboratory and ultrasound examination.
 Insert a foley cathether to accurately record urine ouptut.
 Put patient on NPO status.
 Provide emotional support.
 Emergency cesarean section is undertaken when rapid delivery is needed in
instances of distressed fetus and cannot delivered normally or if complications
arise.

NUTRITION
 Before CS: NPO until reasonable stability is assured and possibility of
immediate cesarean delivery is concluded.
 After CS:
 Protein, calcium and minerals rich food
 Vitamin rich like A and C
 Whole grains
 Fibre rich foods
 Foods that are easy to digest, iron rich and fluids

CORD PROLAPSE