Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about umbilical cord prolapse.

And you can find written notes on this topic at zero to finals.com slash cord prolapse

or in the labour and delivery section of the zero Zero to Finals, Obstetrics and Gynaecology book.

So let's get straight into it.

Cord prolapse is when the umbilical cord descends below the presenting part of the fetus,

so below the head in a normal catholic presentation, and through

the cervix into the vagina, after rupture of the fetal membranes. There's a significant danger

of the presenting part of the fetus, for example the head, compressing the cord, resulting in fetal hypoxia or a lack of oxygen

reaching the fetus.

The most significant risk factor for cord prolapse is when the fetus is in an abnormal

lie after 37 weeks gestation, meaning an unstable, transverse or oblique position to the fetus.

Being in an abnormal lie provides space for the cord to prolapse below the presenting part of the

fetus.

In a longitudinal lie where the fetus is straight up and down in line with the mother,

with a cafalic presentation where the head comes first, the head typically descends into

the pelvis, which means there's no room for the cord to descend or prolapse.

Let's talk about making the diagnosis. Umbilical cord prolapse should be suspected when there are signs of fetal distress on the CTG.

A prolapsed umbilical cord can be diagnosed by a vaginal examination.

A speculum examination can be used if required to confirm the diagnosis.

Finally, let's talk about management.

An emergency cesarean section is indicated where cord prolapse occurs.

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