Woahhh people why so many gynae and obstetric lecture nowadays ah? one lecture after another....anyway, this is very useful for ER nurses when encountering such case. Bare in mind, most obstetric case, labour, etc are only handle by female health care members. So, its a bit hard for male staffs to think about such management, but we watch videos and hope to witness such cases one day..(amin!)
What do you know about cord prolapse(CP)? so far i only know 'Rectal Prolapse'...prolapse suggest that the descending of wat eva into an opening, hence its name. In CP, the cord lead the way ahead of the baby (The Cleveland Clinic Foundation, 2008(2)) Effect, is upon the baby, he/she can get strangulated leading to death, asphyxiation and eventually death.
From our lecture, CP is when the cord descend through the cervix alongside (occult) or past the presenting part (overt) in the presence of rupture membrane(adapted 2008 new definition also from the US). For as long as u see the cord coming through the vagina during labour, always suspect CP.
CP occurs 0.1-0.6% in every birth, aproximately, it happens 1 in every 300 birth(The Cleveland Clinic Foundation, 2008). This also tops 1% in breech delivery. CP causes death(25%-50%from asphyxiation)...banyak to beb!! so why death? ..
1. Due to mechanical compression between the presenting part and bony pelvis.
2. Cause the spasm of the cord vessel (restricted blood supply to the baby).
Also, causes hypoxic ischemic encephalopathy and cerebral palsy.
Management of CP, u can insert 500 cc of normal saline into the bladder via foley's catheter which is describe as to create effect of compression as to prevent the baby from coming out further. Another way, placing two fingers into the vagina and pushing back the baby inwards, the other hand might be needed to put pressure on the suprapubic area. This has to be done until the mother reaches Operating Room or until the obstetrician has arrived to the ED(depends).
Assessment includes, feeling the pulse as for the baby...by assessing the cord to feel if there is a pulsating feeling is going on. Supply the mother with sufficient oxygen(first and always a priority). If no pulsating cord felt..proceed by ultrasound or doppler(doppler was not mentioned inthe lecture so this has to be questioned as doppler also serves in the assessment of present HR of the baby).
Additional info might be need or added....feel free to comment
What do you know about cord prolapse(CP)? so far i only know 'Rectal Prolapse'...prolapse suggest that the descending of wat eva into an opening, hence its name. In CP, the cord lead the way ahead of the baby (The Cleveland Clinic Foundation, 2008(2)) Effect, is upon the baby, he/she can get strangulated leading to death, asphyxiation and eventually death.
From our lecture, CP is when the cord descend through the cervix alongside (occult) or past the presenting part (overt) in the presence of rupture membrane(adapted 2008 new definition also from the US). For as long as u see the cord coming through the vagina during labour, always suspect CP.
CP occurs 0.1-0.6% in every birth, aproximately, it happens 1 in every 300 birth(The Cleveland Clinic Foundation, 2008). This also tops 1% in breech delivery. CP causes death(25%-50%from asphyxiation)...banyak to beb!! so why death? ..
1. Due to mechanical compression between the presenting part and bony pelvis.
2. Cause the spasm of the cord vessel (restricted blood supply to the baby).
Also, causes hypoxic ischemic encephalopathy and cerebral palsy.
Management of CP, u can insert 500 cc of normal saline into the bladder via foley's catheter which is describe as to create effect of compression as to prevent the baby from coming out further. Another way, placing two fingers into the vagina and pushing back the baby inwards, the other hand might be needed to put pressure on the suprapubic area. This has to be done until the mother reaches Operating Room or until the obstetrician has arrived to the ED(depends).
Assessment includes, feeling the pulse as for the baby...by assessing the cord to feel if there is a pulsating feeling is going on. Supply the mother with sufficient oxygen(first and always a priority). If no pulsating cord felt..proceed by ultrasound or doppler(doppler was not mentioned inthe lecture so this has to be questioned as doppler also serves in the assessment of present HR of the baby).
Additional info might be need or added....feel free to comment
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