CORD PROLAPSE

Risk factors for cord prolapse:

• Malpresentations
• Prematurity and/or low birth weight
• Multiple gestation (esp. 2nd twin)
• Polyhydramnios
• Rupture of membranes prior to engagement

Interventions for cord prolapse:

• Maternal position changes (deep Trendelenburg or knee-chest)
• Elevate fetal head
• Manual replacement of the cord is controversial
• Immediate delivery if possible (often will be advantageous to use Assisted Delivery)
• If can't deliver vaginally immediately, consider tocolysis with terbutaline 0.25mg SQ and cesarian delivery

(Sources include 2002 Advanced Life Support in Obstetrics course syllabus; American Academy of Family Physicians)