Op
Typical case. Is. Fre. Floating head with nothing down.. Then rupture of membranes eith water out and then cord. Seen out. Then how to proceed?
call for help ⇒ seniors, obsgyn, pead, anethesias
Cord compression can also be there wihtout rpture of membranes if specially i cephalic presentation and sqeezed there.
Preentation vs presenting part,
If leaking or membraned ruptuted (watery dicharge)then do vaginal and epculum and see whether there is cord prolapse or what there!!
knee chest position is unconfortable - esepcially if epidural given.
And other stuff to prepare are the normal emergency ceasarian stuff thats needed to be done. Entire list for emergency ceasarian.
For cord presentation (not prolapse) if you feel the cord, must not wait till it prolapses - because it will anyway. Must take for emergency ceasrian asap.
Even in preterm delivering the baby will take precedence since the alternative is cord prolapse and death
but if 28 weeks or 24 weeks, then ceasarian section depends on whether the consultant deems that facilities are available to make the fets viable. If its viable then can do ceasrian. If not can wait and watch. Bceause cesarian would mean death and even waiting with cord prolapse might mean death but hope it goes back.
careful pv so that we dont rupture the membranes
FHS documentation after ROM and specifically to check for cord prolapse = occult cord prolapse.
risk factors for eg transverse lie just d ceasrian
High presenting part is dangerous and if high ⇒ can be placenta preavia below or can be cord prolapse later on
Obstrectic manipulation is abig cause.
controlled arm. = small needles and poke
high head is free palpable head.
