Key Aspects of Cord Prolapse
Signs & Symptoms: Sudden, severe, and sustained fetal heart rate decelerations or bradycardia (slow heart rate) following membrane rupture. The cord may be felt during a vaginal examination or, in overt cases, protrude from the vagina. Risk Factors: Conditions that prevent the baby’s head from tightly fitting the cervix, including breech or transverse (malpresentation) positions, premature rupture of membranes, polyhydramnios (excess amniotic fluid), multiple gestation, and obstetric procedures like artificial rupture of membranes. Management & Emergency Action: Immediate, rapid delivery (often by C-section) is crucial. While preparing for surgery, the presenting part (baby) must be manually lifted off the cord to relieve pressure. Maternal positioning, such as the knee-chest or exaggerated Trendelenburg (head-down) position, is used to reduce cord compression. Complications: Can lead to severe fetal hypoxia, brain injury, or fetal death due to restricted blood flow.
