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Management of cord prolapse

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The aim of the management in the few minutes it takes to perform a caesarian section is to prevent the compression of the cord by the presenting part. Thus:

  • determine if the cord is still pulsating

  • if the cord is pulsating then push any exposed loop back into the vagina so to keep it warm and moist

  • displacement of the presenting part, in particular during a contraction, by putting a hand in the vagina, so that the presenting part does not compress the cord

  • positioning the woman such that gravity tends to keep the presenting part off the cord, i.e. knee-elbow position

  • infusion of fluid, e.g. 500 ml saline, into the bladder, via a size 16 catheter

  • keeping the cord in the vagina and avoiding handling in order to prevent spasm

Note: If the presenting part is sufficiently low in the pelvis and the cervix is fully dilated then an experienced obstetrician might undertake a vaginal delivery (forceps if cephalic presentation or breech extraction). Otherwise an immediate caesarian section is indicated.

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