Prolapsed cord

  1. Prepare for an emergency cesarean section. If unable, temporize:
  2. Place the mother in knee-chest or deep Trendelenburg (head-down) position
  3. Minimize compression of the umbilical cord by inserting a sterile gloved hand and exerting manual pressure in the vagina to lift and maintain the presenting part away from the prolapsed cord
  4. After manual elevation of the presenting part, instill 500 mL of saline into the bladder to raise the presenting part and maintain cord decompression.
  5. Tocolytic therapy can be administered to decrease uterine contractions.