Prolapsed cord

Essential equipment

Steps

  1. Once identified on pelvic exam, insert a sterile gloved hand and lift presenting part off of cord

  2. Do no remove hand and do not attempt to reduce the cord

  3. Call for help: OB and NICU/Pediatrics/colleague/ancillary staff

  4. Arrange for an emergency cesarean section. In the meantime, temporize

  5. Place mother in knee-chest or deep Trendelenburg (head-down) position (keep the patient in this position). Encourage mother not to push or cough

  6. Tocolytic therapy (Terbutaline, Nifedipine, Magnesium sulfate) can be administered to decrease uterine contractions and improve fetoplacental perfusion