Seminar On

Cord prolapse

Submitted to :

Mrs.

PadmavathiLecturer

NCON , Raichur

Submitted by :

Felix JosephIV th BSc Nursing

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 applicationintra uterine pressureCatheter placementForceps applicationManual rotationAmnio 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.

DiagnosisDiagnosis

• 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 monitoringContinuous fetal monitoring

Prevention >>

• NoNo 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