CORD PROLAPSE

HI! GOOD DAY, THIS IS DARWIN QUIRIMIT YOUR 3) MAAM, YOU WILL BE PLACED ON THE
STUDENT NURSE IN-CHARGED FOR TODAY & I WILL BE EXAMINATION TABLE TO INSPECT YOUR LABOR
DEMONSTRATING EMERGENCY MANAGEMENT FOR PROGRESS. ASSESS THE CLIENT THERE 3 POSITIONS
PROLAPSE OF UMBILICAL CORD. ARE EMPLOYED FOR INTERNAL EXAMINATION:

PROLASE OF THE UMBILICAL CORD: - DORSAL RECUMBENT, SIM’S POSITION AND KNEE-
 PROLAPSE MAY OCCUR AT ANY TIME AFTER THE CHEST POSITION
MEMBRANE RUPTURE IF THE PRESENTING FETAL
PART IS NOT FITTED FIRMLY AND TO THE CERVIX. THE AFOREMENTIONED POSITIONS ARE MADE BEST SO
AS TO EXPOSE THE GYNECOLOGIC AREA TO BE
IT TENDS TO OCCUR MOST UP THEN WITH: EXAMINED. AND POSITON DEPENDS ON CLIENT’S
 PREMATURE RUPTURE OF MRMBRANE CAPABILITY & EXAMINER’S PREFERRED POSITION.
 FETAL PRESENTATION OTHER THAN CEPHALIC
 PLACENTA PREVIA 4) I WILL DRAPE THE CLIENT & EXPOSE ONLY THE
 INTRAUTERINE TUMORS PREVENTING THE GYNECOLOGICAL AREA.
PRESENTING PART FORM ENGAGING. ALWAYS RESPECT THE CLIENT’S MODESTY AND PROVIDE
 A SMALL FETUS PRIVACY.
 CPD PREVENTING FIRM ENGAGEMENT 5) NEXT, I WILL DO HANDWASHING AND PUT THE
 POLYHYDRAMINOS EXAMANITION GLOVES. THIS WILL PROTECT
 MULTIPLE GESTATION MYSELF FROM CONTACTING GYNECOLOGICAL
FOR THE ASSESSMENT: DISEASES CAUSED BY HIGHLY INFECTIVE
 ASSESS THE WOMAN TO BE TRANSFERRED TO THE ORGANISMS.
NEAREST CONSULTANT UNIT/HOSPITAL FOR
DELIVERY; AND 6) MA’AM, PLEASE TAKE A DEEP BREATH WHILE I
 ASSESS THE CLIENT’S ABILITY TO FOLLOW INSERT MY TWO FINGERS AND PERFORM THE
INSTRUCTIONS. INTERNAL EXAMINATION. IF I SEE A CORD
PROTRUDING ON THE VAGINA I WILL HANDLE IT
SO LET’S START… CAREFULLY.
ON INSPECTION THE CORD WILL BE VISIBLE AT THE
1) I WILL GATHER ALL ITEMS THAT I WILL NEED ON VULVA AND TO ASSESS THE CORD FOR PULPATIONS.
THIS PROCEDURE.
FOR THE VAGINAL DELIVERY: 7) I WILL NOW CHECK YOUR BABY'S HEART RATE WITH
THE STETHOSCOPE ON YOUR ABDOMEN.
FOR THE INTERNAL
 2 STERILE GLOVES - CORD PROLAPSE IS IDENTIFIED ON A FETAL MONITOR
EXAMINATION: ONLY AFTER THE MEMBRANES HAVE RUPTURED, WHEN
 1 STRAIGHT FORCEPS - THE FHR IS DISCOVERED TO BE UNUSUALLY SLOW OR A
CLEAN GLOVES; AND VARIABLE DECELERATION FHR PATTERN.
 1 MAYO SCISSORS - -TO ELIMINATE CORD PROLAPSE, ALWAYS EVALUATE
LUBRICANT FETAL HEART SOUNDS IMMEDIATELY AFTER MEMBRANE
 URINARY CATHETER RUPTURE, WHETHER SPONTANEOUS OR AMNIOTOMY.
 PLACENTAL BASIN
 1 NEEDLE HOLDER “IF YOU’RE IN A CEMONC (OR COMPREHENSIVE
 1 SYRINGE W/ NEEDLE EMERGENCY OBSTETRIC AND NEW BORN CARE) FACILITY
 1 CHROMIC 2 REPORT THE FINDINGS TO THE OBSTETRICIAN FOR
 2% LIDOCAINE EMERGENCY CESAREAN SECTION”
 COTTON BALLS W/ BETADINE
 STERILE OPERATING SPONGE BUT, “IF YOU’RE IN A BEMONC (OR BASIC EMERGENCY
THIS PROCEDURE IS IMPORTANT FOR EASY OBSTETRIC AND NEW BORN CARE) FACILITY THE
ACCESSIBILITY FOR THE INSPECTION OF THE EXTERNAL FOLLOWING PROCEDURES BELOW ARE EMERGENCY
GENTITALIA, VAGINA, & CERVIX MANAGEMENT FOR PROLAPSE OF THE UMBILICAL
2) HI MA’AM, GOOD DAY I AM DARWIN THE STUDENT CORD.
NURSE FOR TODAY. MAY I KNOW YOUR NAME IS?
THANK YOU. AND I WILL DO INTERNAL 8) MA'AM, I WILL ASSIST YOU IN GETTING INTO A
EXAMINATION TO ASSESS THE PROGESS OF YOUR KNEE CHEST POSITION, TAKE A DEEP BREATHE, AND
LABOR. DO NOT BEAR DOWN IF YOU HAVE TO.
IT IS IMPORTANT TO OBTAIN CLIENT’S COOPERATION & KNEE-CHEST POSITION AND USES GRAVITY TO SHIFT THE
WORK SIMULTANEOUSLY. FETUS OUT THE PELVIS.
 CORD PROLAPSE
RATIONALE:
9) MA’AM I WILL BE INSERTING CATHETER INTO YOUR • Elevation of the presenting part is thought to relieve
URINARY BLADDER BY A STERILE FLUID TO HELP IN pressure on the umbilical cord and prevent mechanical
REDUCING THE COMPRESSION ON THE PROLAPSE vascular occlusion.
CORD. • Manual elevation is performed by inserting a gloved
- SO LET’S ASSUME THAT THEIR HAS STERILE IV FLUIDS. hand or two fingers in the vagina and pushing the
THEN THE CATHETER SHOULD BE CLAMP ONCE 500- presenting part upwards.
700ML HAVE BEEN INSTILLED
- BEFORE ANY DELIVERY ATTEMPT, WHETHER VAGINAL • Excessive displacement may encourage more cord to
OR CESAREAN SECTION (CS), IT IS ESSENTIAL TO RE- prolapse
EMPTY THE BLADDER • To prevent vasospasm, there should be minimal
handling of loops of cord lying outside the vagina.
10) MAAM, I WILL PUT MY GLOVED HANDS INTO YOUR
VAGINA TO PUSH THE HEAD OF YOUR BABY
UPWARD & TAKE A DEEP BREATH WHEN YOU HAVE
THE URGE TO BEAR DOWN.
- IT IS IMPORTANT TO NOT REMOVE YOUR FINGERS
UNTIL YOU ARRIVED IN THE OPERATING ROOM OR BY
INSTRUCTION OF THE OBSTETRICIAN.

11) AFTER THE CS, CALL OUT THE TIME OF BIRTH AND
GENDER OF THE BABY. IF THE BABY IS CRYING I WILL
PROCEED TO EINC BUT IF NOT I WILL CUT THE CORD
& RESUSCITATE THE INFANT IF NEEDED.
THIS WILL PROTECT THE MOTHER AND THE BABY FROM
INFECTION AND ALLOW THE INFANT TO BREATHE ON
HIS OWN.

12) AFTER THE PROCEDURE I WILL REMOVE THE

GLOVES AND WASH MY HANDS FOR INFECTION
CONTROL.

13) FINALLY, IN ORDER TO PROVIDE ACCURATE DATA IN

THE CLIENT'S CARE, I WILL DOCUMENT THE DATE,
TIME, AND PROCEDURE.

THAT’S ALL THANK YOU FOR LISTENING!!

10. MAAM, I WILL PUT MY GLOVED HANDS INTO YOUR

VAGINA TO PUSH THE HEAD OF YOUR BABY UPWARD &
TAKE A DEEP BREATH WHEN YOU HAVE THE URGE TO
BEAR DOWN.
- IT IS IMPORTANT TO NOT REMOVE YOUR FINGERS
UNTIL YOU ARRIVED IN THE OPERATING ROOM OR BY
INSTRUCTION OF THE OBSTETRICIAN.