Article ID Journal Published Year Pages File Type
3967030 Obstetrics, Gynaecology & Reproductive Medicine 2013 5 Pages PDF
Abstract

Cord prolapse is an obstetric emergency that complicates 0.1–1% of all deliveries with significant perinatal morbidity and mortality. Early diagnosis and swift management improves fetal outcomes. Immediate interventions include manual elevation of the presenting part, altered maternal position and filling of the bladder. Delivery is usually by Caesarean section unless the cervix is fully dilated when an instrumental delivery can be considered.Face presentation accounts for 0.2% of all live births. The overall vaginal delivery rate is 60–70% with the majority being in mento-anterior position. Those in persistent mento-posterior position usually require Caesarean section. Forceps delivery can be performed for prolonged second stage or abnormal CTG in mento-anterior position.Primary dysfunctional labour is very common. Interventions to consider include intravenous hydration, amniotomy and oxytocin. Oxytocin reduces the length of labour but does not alter the mode of delivery. Continuous fetal monitoring must be employed when utilizing oxytocin.

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