Page 272 - Critical Maternity & Newborn Health Nursing

Under no circumstances should the membranes be ruptured.

-The nurse should discontinue the vaginal examination, in order to

reduce the risk of rupturing the membranes.

-Medical aid should be summoned. To assess fetal well-being

continuous electronic fetal monitoring should be commenced or the

fetal heart should be auscultated as continuously as possible.

- The mother should be helped into a position that will reduce the

likelihood of cord compression.

-Caesarean section is the most likely outcome.

Cord prolapse diagnosis

Whenever there are factors present that predispose to cord prolapse a

vaginal examination should be performed immediately on
spontaneous rupture of membranes.

Bradycardia

- Variable Or Prolonged Decelerations Of The Fetal Heart are

associated with cord compression

-The diagnosis of cord prolapse is made when the cord is felt below

or beside the presenting part on vaginal examination.

-The cord may be felt in the vagina or in the cervical os or a loop of

cord may be visible at the vulva

Management

Immediate action

271 Table of Contents