Cord prolapse

• This is when the cord lies in front of the

presenting part with ruptured membranes
• Diagnosis may be through vaginal examination
after membranes have ruptured where it is
felt in the vagina or it may be seen at the
vulva.
• Fetal heart rate deceleration may also be felt
on auscultation
 Management
• Note the time and call for medical aid.
• Stop any oxytocin drip and position the mother to
relieve cord compression
• If the cord loop is visible at the vulva, clean it with
warm nomal saline and replace it in the vagina to
maintain warmth and prevent spasms and stop
drying
• Administer oxygen to the mother by mask 4l/minute
• Start iv fluids eg ringers lactate or normal saline
• Give salbutamol to relieve contractions
 Relieving pressure
• Keep fingers inside the vagina to push up the presenting
part off the cord to relieve cord pressure which can cause
fetal hypoxia
• Raise the pelvis and buttocks of the mother to release
pressure of the presenting part on the cord.
• You can use pillows (exaggerated sims position)
• You can adopt a knee-chest position to turn the
gravitational force towards the diaphragm
• The foot of the bed may also be raised
• Bladder filling can also be help in managing the cord
prolapse whereby 500-700mls of sterile saline water is
filled through a folley catheter to the bladder
• This helps in reliving pressure from the cord by elevating
the presenting part 2cm above the the ischial spines
• The bladder should be drained in theatre before c/s
• Prepare the mother for emergency c/s
• If in 2nd stage you can hasten the delivery
• In community arrange for immediate referral for c/s and at
the same time carry out the immediate care to relieve
compression during the referral process