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
Author: Medzcool

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.


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
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