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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