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Cord Prolapse
Cord Prolapse and Breech.
| Question | Answer |
|---|---|
| Define cord prolapse. | The descent of the umbilical cord through the cervix alongside or past the presenting part in the presence of ruptured membranes. |
| Is cord prolapse common? | No it is rare with an incidence of 1:426. |
| Is perinatal mortality high with cord prolapse? | Yes with an incidence of 91:1000. |
| What is the most common form of breech presentation? | Footling Breech. |
| What are the three types of breech presentation from highest to lowest incidence? | Footling, Complete Breech,Frank Breech. |
| What is vertex fetal position? | Head first, the most desirable position. |
| What factors contribute to cord prolapse? | Malpresentation. High presenting part. Prematurity - <2550g or <37/40. Polyhydramnios. Long cord. Mulriparity. Multiple gestation, second twin. Iutrogenic - manipulation, artificial membrane rupture. Placental issues-praevia, abruption. |
| Is it more likely for a before term breech to become cephalic spontaneously? | Yes. |
| What are the chances of having a breech with a preterm <2500g? | 12% |
| What are the chances of having a breech with a normal term baby? | 1% |
| What are the chances of having a breech with a full term baby >3500g? | 12%. |
| What are the complications of vaginal birth? | Cord prolapse, Entrapment of the fetal head, Deflexed head, Pressure on the cord in the first stage. Increased incidences of premature placental separation. |
| What are the main causes of morbidity in vaginal breech birth? | Intracranial haemorrhage, Asphyxia, Hypoxia, Fractures. |
| What fractures are seen in vaginal breech birth? | Humerous, Clavicle, Femur, Cervical spine. |
| Define lithotomy. | Position in which the patient is on their back with hips and knees flexed and thighs apart. |
| Define brachial plexus injuries, common in breech with nuchal arms presentation. | Injury of the network of nerves that conducts signals from the spinal cord, which is housed in the spinal canal of the vertebral column ,to the shoulder, arm and hand. |
| Define nuchal arms. | This is when one or both arms are causing obstruction. |
| What maneuver is used for nuchal presentation? | Loveset's Maneuver. |
| What may be the cause of fetal head entrapment? | The cervix may not be fully dilated. |
| Is head entrapment more common with preterm babies and why? | Yes, because their heads are significantly larger than their heads, preterm babies are also smaller than normal permitting birth faster than normal, eg cervix is not fully dilated yet. |
Created by:
boermedic
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