Cord Prolapse

CORD PROLAPSE

Q. 1

A 38 week pregnant primigravida with breech presentation is found to have cord prolapse. LEAST chances of cord prolapse are seen in:

 A

Frank breech

 B

Complete breech

 C

Footling

 D

Knee

Q. 1

A 38 week pregnant primigravida with breech presentation is found to have cord prolapse. LEAST chances of cord prolapse are seen in:

 A

Frank breech

 B

Complete breech

 C

Footling

 D

Knee

Ans. A

Explanation:

Umbilical cord compression and prolapse may be associated with breech delivery, particularly in complete (5%) and footling (15%) presentations. 

  • This is due to the inability of the presenting part to fill the maternal pelvis, either because of prematurity or poor application of the presenting part to the cervix so that the umbilical cord is allowed to prolapse below the level of the breech. 
  • Frank breech presentation offers a contoured presenting part, which is better accommodated to the maternal pelvis and is usually well applied to the cervix. 
  • The incidence of cord prolapse in frank breech is only 0.5% (the same as for cephalic presentations).
 
Ref: Kish K., Collea J.V. (2007). Chapter 21. Malpresentation & Cord Prolapse. In A.H. DeCherney, L. Nathan (Eds), CURRENT Diagnosis & Treatment Obstetrics & Gynecology, 10e.

Q. 2

Cord prolapse is most commonly associated with:

 A

Transverse lie

 B

Breech

 C

Contracted pelvis

 D

Prematurity

Q. 2

Cord prolapse is most commonly associated with:

 A

Transverse lie

 B

Breech

 C

Contracted pelvis

 D

Prematurity

Ans. A

Explanation:

Transverse lie


Q. 3

Best treatment of Cord prolapse is :

 A

Replace the cord in vagina

 B

Cesarean section

 C

Immediate vaginal delivery

 D

None of the above

Q. 3

Best treatment of Cord prolapse is :

 A

Replace the cord in vagina

 B

Cesarean section

 C

Immediate vaginal delivery

 D

None of the above

Ans. B

Explanation:

Cesarean section


Q. 4

The chief cause of perinatal mortality in the type of fetal life shown in the photograph below is ? 

 A

Intracranial hemorrhage.

 B

Prolapse of umbilical cord.

 C

Delay in delivery of head.

 D

Abnormalities.

Q. 4

The chief cause of perinatal mortality in the type of fetal life shown in the photograph below is ? 

 A

Intracranial hemorrhage.

 B

Prolapse of umbilical cord.

 C

Delay in delivery of head.

 D

Abnormalities.

Ans. A

Explanation:

The fetal life type as shown in the picture above represents Frank breech. In this position, the baby’s buttocks are aimed at the birth canal with its legs sticking straight up in front of his or her body and the feet near the head.

The chief cause of perinatal mortality in these cases are Intracranial hemorrhage.


Q. 5

Which of the following is not an etiology of cord  prolapse?

 A

Contracted pelvis

 B

Hydramnios

 C

Placenta previa

 D

Dextrarotated uterus

Q. 5

Which of the following is not an etiology of cord  prolapse?

 A

Contracted pelvis

 B

Hydramnios

 C

Placenta previa

 D

Dextrarotated uterus

Ans. D

Explanation:

Dextrarotated uterus is a normal physiological changed seen in pregnancy.

ETIOLOGY:
  • Malpresentations:transverse (5–10%) and breech (3%)
  • Contracted pelvis
  • Prematurity
  • Twins
  • Hydramnios
  • Placental factor:placenta previa
  • Iatrogenic: lLow rupture of the membranes, manual rotation of the head, ECV, IPV
  • Stabilizing induction




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