What is a prolapsed cord?

What is a prolapsed cord?

• A. Cord comes out of the uterus before the baby
• B. Cord wraps around the baby's neck
• C. Umbilical cord becomes detached
• D. Cord is compressed inside the uterus

Answer: (A)

Prolapsed cord is when the umbilical cord slides down and passes into the birth canal ahead of the baby after the membranes rupture. The phrase “cord comes out of the uterus before the baby” describes this exact event, making it an obstetric emergency because the exposed cord can be compressed by the presenting part or contractions, leading to reduced oxygen delivery to the fetus. The other scenarios describe different cord problems that aren’t prolapse: a cord around the baby’s neck is a nuchal cord, cord detachment is not prolapse, and cord compression inside the uterus without the cord protruding into the birth canal is a separate danger but not prolapse. In the EMS setting, suspect prolapse if you see or suspect the cord in the vagina; immediately reduce pressure on the cord by lifting the presenting part with a gloved hand, avoid pushing the cord back in, place the patient in a knee-chest or Trendelenburg position, cover the cord with moist sterile dressings if exposed, and transport rapidly with high-flow oxygen to the mother.

Prolapsed cord is when the umbilical cord slides down and passes into the birth canal ahead of the baby after the membranes rupture. The phrase “cord comes out of the uterus before the baby” describes this exact event, making it an obstetric emergency because the exposed cord can be compressed by the presenting part or contractions, leading to reduced oxygen delivery to the fetus.

The other scenarios describe different cord problems that aren’t prolapse: a cord around the baby’s neck is a nuchal cord, cord detachment is not prolapse, and cord compression inside the uterus without the cord protruding into the birth canal is a separate danger but not prolapse. In the EMS setting, suspect prolapse if you see or suspect the cord in the vagina; immediately reduce pressure on the cord by lifting the presenting part with a gloved hand, avoid pushing the cord back in, place the patient in a knee-chest or Trendelenburg position, cover the cord with moist sterile dressings if exposed, and transport rapidly with high-flow oxygen to the mother.