Cord Prolapse- Felix
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Seminar On Cord prolapse Submitted to : Mrs.
Padmavathi Lecturer NCON , Raichur
Submitted by :
Felix Joseph IV 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 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 > [email protected]
Padmavathi Lecturer NCON , Raichur
Submitted by :
Felix Joseph IV 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 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 > [email protected]
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