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Cord Presentation and Prolapse

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Cord Presentation and Prolapse Powered By Docstoc
					‫بسم هللا الرحمن الرحيم‬
Cord presentation
   &prolapse

      Dr. Adel Nada.
  Lecturer in OBS&GYN.
   Faculty of medicine
     Cairo university
        Cord presentation
          and prolapse


Definitions :
Cord presentation: The cord lies below the presenting part
           with intact membranes.

 Cord prolapse: The cord lies below the presenting part with rupture of membranes
The incidence: It is a rare condition occurs in 1/300
cases.
It carries high fetal morbidity & mortality (why?)
Predisposing factors: Long cord ,malpresentation &non
engagement.
Diagnosis: Cord presentation is seldom diagnosed during
pregnancy or early in labor.
Cord pulsation can be felt with intact membranes through
dilated cervix.
Fetal bradycardia during descent of presenting part.
In cord prolapse: The cord may be seen at the
vulva or felt in the vagina below presenting part.
IT IS A RULE TO DO PV AFTER RUPTURE OF
MEMBRANES.
Prolapsed pulsating cord :The fetus is alive .
Prolapsed non pulsating cord: The fetus is usually dead .
N.B. Sometimes pulsations can not be felt in living fetus due
to compression& we have to check buy sonicade or portable
U/S.
PROGNOSIS:
Severe bradycardia or absent
pulsation indicates poor fetal
outcome.
Stillbirth &neonatal death occurs
in 20 %.
Urgent CS improves fetal
outcomes.
           Management
Prolapsed non pulsating cord: The
condition is not urgent &vaginal delivery is
the rule.
Prolapsed pulsating cord :Urgent CS is the
rule (unless?).
IF rarely CX fully dilated &head engaged
,we do forceps or vacuum extraction.
      Complex presentation
It is rare condition in
which part of the limb
lies below the head .
If diagnosed during
labor ,we try
reposition of the limb
&allow for vaginal
delivery.
Cord presentation &prolapse
Complex presentation
THANK
  YOU
 NILLY

				
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posted:2/3/2012
language:English
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Description: cord presentation, cord prolapse, obstetric emergency.