Umbilical cord prolapse - Revision history

Rossdonaldson1: /* Background */

2024-12-11T20:49:07Z

Background

← Older revision		Revision as of 20:49, 11 December 2024
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	*Occurs in 0.5% of pregnancies		*Occurs in 0.5% of pregnancies
	*Likely secondary to the presenting fetal part not filling enough of the lower uterus and allowing cord to present first during labor.<ref name="Mercado">Mercado J, Brea I, Mendez B, et al. Critical obstetric and gynecologic procedures in the emergency department. Emerg Med Clin North Am. 2013 Feb;31(1):207-36.</ref>		*Likely secondary to the presenting fetal part not filling enough of the lower uterus and allowing cord to present first during labor.<ref name="Mercado">Mercado J, Brea I, Mendez B, et al. Critical obstetric and gynecologic procedures in the emergency department. Emerg Med Clin North Am. 2013 Feb;31(1):207-36.</ref>
	*Risk factors<ref name="Mercado" />
	**Low birth weight		===Risk factors===
	**Multiparity		**Low birth weight<ref name="Mercado" />
	**Fetal malpresentation		**Multiparity<ref name="Mercado" />
			**Fetal malpresentation<ref name="Mercado" />

	==Clinical Features==		==Clinical Features==

2024-12-11T20:48:14Z

Management

← Older revision		Revision as of 20:48, 11 December 2024
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	==Management==		==Management==
			[[File:Position Knee Chest.jpg\|thumb\|Image of knee-chest position.]]
	*Emergent OB/Gyn consult		*Emergent OB/Gyn consult
	*Do NOT attempt to reduce cord		*Do NOT attempt to reduce cord

2024-12-11T20:45:43Z

Clinical Features

← Older revision		Revision as of 20:45, 11 December 2024
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	==Clinical Features==		==Clinical Features==
			[[File:Cord.prolaps.jpg\|thumb\|Umbilical cord prolapse cord in the vaginal canal (red arrow).]]
	*Presentation of umbilical cord before fetal delivery (can be felt as pulsatile structure on exam)		*Presentation of umbilical cord before fetal delivery (can be felt as pulsatile structure on exam)

2021-06-16T16:47:49Z

Management

← Older revision		Revision as of 16:47, 16 June 2021
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	==Management==		==Management==
	*Emergent OB/Gyn consult		*Emergent OB/Gyn consult
	*Do NOT attempt to reduce cord ~~- instead, elevate the~~ presenting fetal part to reduce compression and transport to OR for emergent C-section<ref>Holbrook BD. Umbilical cord prolapse. Obstet Gynecol Clin North Am. 2013 Mar;40(1):1-14.</ref>		*Do NOT attempt to reduce cord
			*Elevate presenting fetal part to reduce compression and transport to OR for emergent C-section<ref>Holbrook BD. Umbilical cord prolapse. Obstet Gynecol Clin North Am. 2013 Mar;40(1):1-14.</ref>
	**Examiner who diagnosed umbilical cord prolapse must maintain umbilical decompression until patient is in OR		**Examiner who diagnosed umbilical cord prolapse must maintain umbilical decompression until patient is in OR
	*Place patient in knee-chest position and encourage not to push or cough<ref name="Mercado" />		*Place patient in knee-chest position and encourage not to push or cough<ref name="Mercado" />
			**May also consider Trendelenburg position (if patient can tolerate) to let gravity assist in moving fetus off pelvic floor

	==Disposition==		==Disposition==

2019-05-08T21:14:59Z

Clinical Features

← Older revision		Revision as of 21:14, 8 May 2019
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	==Clinical Features==		==Clinical Features==
	*Presentation of ~~ubmilical~~ cord before fetal delivery (can be felt as pulsatile structure on exam)		*Presentation of umbilical cord before fetal delivery (can be felt as pulsatile structure on exam)

	==Differential Diagnosis==		==Differential Diagnosis==

2016-07-26T07:59:30Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-01T18:56:44Z

Text replacement - " pt " to " patient "

← Older revision		Revision as of 18:56, 1 July 2016
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	*Emergent OB/Gyn consult		*Emergent OB/Gyn consult
	*Do NOT attempt to reduce cord - instead, elevate the presenting fetal part to reduce compression and transport to OR for emergent C-section<ref>Holbrook BD. Umbilical cord prolapse. Obstet Gynecol Clin North Am. 2013 Mar;40(1):1-14.</ref>		*Do NOT attempt to reduce cord - instead, elevate the presenting fetal part to reduce compression and transport to OR for emergent C-section<ref>Holbrook BD. Umbilical cord prolapse. Obstet Gynecol Clin North Am. 2013 Mar;40(1):1-14.</ref>
	**Examiner who diagnosed umbilical cord prolapse must maintain umbilical decompression until pt is in OR		**Examiner who diagnosed umbilical cord prolapse must maintain umbilical decompression until patient is in OR
	*Place pt in knee-chest position and encourage not to push or cough<ref name="Mercado" />		*Place patient in knee-chest position and encourage not to push or cough<ref name="Mercado" />

	==Disposition==		==Disposition==

2016-03-22T14:21:07Z

2015-08-04T07:17:04Z

2015-08-04T06:54:36Z