Optimal management of umbilical cord prolapse

International Journal of Women's Health
Waleed Ali Sayed Ahmed, Mostafa Ahmed Hamdy

Abstract

Umbilical cord prolapse (UCP) is an uncommon obstetric emergency that can have significant neonatal morbidity and/or mortality. It is diagnosed by seeing/palpating the prolapsed cord outside or within the vagina in addition to abnormal fetal heart rate patterns. Women at higher risk of UCP include multiparas with malpresentation. Other risk factors include polyhydramnios and multiple pregnancies. Iatrogenic UCP (up to 50% of cases) can occur in procedures such as amniotomy, fetal blood sampling, and insertion of a cervical ripening balloon. The perinatal outcome largely depends on the location where the prolapse occurred and the gestational age/birthweight of the fetus. When UCP is diagnosed, delivery should be expedited. Usually, cesarean section is the delivery mode of choice, but vaginal/instrumental delivery could be tried if deemed quicker, particularly in the second stage of labor. Diagnosis-to-delivery interval should ideally be less than 30 minutes; however, if it is expected to be lengthy, measures to relieve cord compression should be attempted. Manual elevation of the presenting part and Vago's method (bladder filling) are the most commonly used maneuvers. Care should be given not to cause cord spasm with excessive m...Continue Reading

Citations

Aug 29, 2020·Obstetrical & Gynecological Survey·Megan PaganEverett F Magann
Dec 3, 2020·NeoReviews·Devon Abt, Toni Golen
Feb 18, 2021·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·M ChateletF Amiot
Jun 29, 2021·American Journal of Obstetrics and Gynecology·Lo WongTak Yeung Leung
Aug 20, 2021·Frontiers in Pediatrics·Mark S Scher

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BETA
cesarean section

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