Case No. 63

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Case No. 63

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Chief Complaint:

Cord prolapse during pregnant delivery

Published: July 26, 2017
Case No. 63
Author: Medzcool
CASE SCENARIO

A 24 year old G1P0 female at 39 weeks gestation presents to the emergency department with contractions. Patient reports “my water broke and I’m having contractions”. The patient’s prenatal course has been uncomplicated. On exam, you place the patient on a monitor and note fetal heart rate tracings showing variable decelerations and episodes of bradycardia. Pelvic exam reveals a palpable cord protruding from the cervix.

QUESTION

What is the next best step in management?

Emergent bedside cesarean section
Manual elevation of the presenting fetal part
Start tocolytics
Push the fetus back into the uterus and prepare for delivery
Reduce the umbilical cord