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Cord Prolapse

Prepared by:
Dr. Gehanath Baral
MBBS,DGO,MD
Senior Consultant Gynecologist & Obstetrician: Government of
Nepal
Visiting Professor: CTGU
29th March,2007

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Types
Membrane

Intact Ruptured

Cord felt below Cord at the side Cord inside vagina


presenting part of presenting part or outside vulva

Cord prolapse
Cord presentation Occult prolapse
(1:300)

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Cause
1. Malpresentation Transverse, Breech,
Face
2. Contracted pelvis
3. Premature
4. Twins
5. Polyhydramnios
6. Iatrogenic ARM, Version

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Precaution

1. ARM Controlled

2. P/V exam before & after rupture of


membrane

3. Unexplained fetal distress Cord


presentation or occult prolapse
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Management
Cord
prolapse

Live baby Dead baby

Eary delivery Early delivery Spontaneous/


not possible possible Destructive del.

1.Elevate foot end


Vertex
2.Knee-chest position
3.Bladder filing
CS Forcep/Vacuum

Breech
Extraction

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Complication
1. Fetal hypoxia/Distress
2. Intrapartum fetal death
3. Operative delivery
– Forceps del./Vacuum del.
– CS del.
1. Anesthesia
2. Hemorrhage
3. Infection