Cord Prolapse

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Predisposing factors for possible cord prolapse
- Premature
- Multiples
- Multiparity
- Polyhydramnios
- Malpresentation
Signs of Possible Prolapse
- Sudden fetal bradycardia
- VD's that worsen
Types of prolaps
- Occult - in lower uterine segment, inner cervix; along side presenting part
- Funic - palpate in front of presenting part
- Overt - slips through cervix, into vaginal vault
Management of Prolapse
- EMERGENCY!
- Do not leave her, have others call MD/OR team; start IV, O2, Continuous EFM
- Sterile glove, insert hand, firmly press upward on presenting part to resolve compression
- DO NOT REPLACE CORD!!!
- Stay there until in OR, under surgical scrubs, and baby is born by CS