Umbilical Cord Prolapse

Slip

Step 1: View clinicals

A 32 year old lady in her fourth pregnancy presents at 37 weeks of gestation following spontaneous rupture of membranes. Her pregnancy was uncomplicated. Her only comorbidity is mild intermittent bronchial asthma, with no recent exacerbations.


Step 2: Order all relevant investigations

Fetal doppler auscultation

Fetal heart sounds are noted.

Group & cross-match blood

Her blood group is A +ve (positive). 1 pint of blood is cross matched.

Transvaginal Ultrasound Scan

You realize that a transvaginal ultrasound scan might irritate the cord and cause vasospasm.

Cardiotocography

You realize that cardiotocography may result in unnecessary delay.


Step 3: Select appropriate management

Knee-chest position
Warm saline vaginal pack
Bladder : saline infusion
Vacuum Extraction


Score: ★★☆