1. Prolapsed Cord Dr Maryam

2. Prolapsed Cord In order to understand about 'what is prolapsed cord', you can visualize the normal consequences in natural child birth. As we all know, the umbilical cord is a tube like, flexible part that connects the developing fetus to the mother for nutrition. In rare instances, the cord drops or falls into the open cervix, and reaches the vaginal opening before and during child delivery. Such a condition is referred to as cord prolapse. Eventually the fallen cord may get entangled against the baby's body, thus increasing pressure in the cord and disturbing a smooth delivery Dr Maryam

3. Definition Descent of the umbilical cord through the cervix alongside (occult) or past the presenting part (overt) in the presence of ruptured membranes. Dr Maryam

4. Cases of cord prolapse appear consistently in perinatal mortality enquiries, and one large study found a perinatal mortality rate of 91 per 1000. Dr Maryam

5. Risk factors of umbilical Cord Prolapse General Long umbilical cord Abnormal location on placenta Small or preterm infant Polyhydramnios Multiple gestation Obstetric procedure Amniotomy before fetal head is engaged : main reason IUPC placement External cephalic version Dr Maryam

6. signs and symptoms Cord observed or palpated during vaginal examination. Bradycardia following ROM Repetitive, variable decelerations Prolonged decelerations (>15 bpm lasting 2 mins or longer yet <10 mins) The most concerning issue : may occur without any physical symptoms. In some, the fetal heartbeat is normal. Timely diagnosis of prolapsed cord is difficult in some cases. Dr Maryam

7. Therapeutic intervention Lowering the pressure in the umbilical cord and delivering vaginally as soon as possible to avoid loss of oxygen. Delivering the fetus with an emergency c-section. Dr Maryam

8. Nursing Intervention Assess fetal viability Call for assistance Prepare for emergency c-section Relieve pressure from cord (usually presenting part) Continuous manual relief of pressure from presenting part Avoid excessive manipulation of cord Re-position client: Trendelenburg, or knee-chest Prepare for emergency delivery Administer oxygen by mask 10-12 L/min Fill maternal bladder with 500-700 cc NS Continuous fetal monitoring Possible neonatal resuscitation (notify neonatal team per hospital protocol) Dr Maryam

9. With recent prolapsed cord nursing intervention, the mortality rate of fetus has been decreased significantly. Dr Maryam