Care of umbilical cord prolapse

  Cord prolapse is defined as the rupture of the fetal membranes and the umbilical cord is located below the previa or enters the vagina through the cervix, or even prolapses out of the vulva through the vagina. The risk of cord prolapse may occur in any case where the prepubic part is not connected to the pelvis. Common risk factors include: abnormal fetal position, high fetal head floating, cephalopelvic disproportion, premature rupture of fetal membranes, preterm delivery, multiple pregnancies, excessive amniotic fluid, and inappropriate manual rupture of the umbilical cord. In particular, mothers with the above risk factors need to take proper and effective care measures as early as possible.  1. Perinatal care: strengthen regular prenatal checkups, prenatal education, enhance maternal awareness of self-care, prevent preterm delivery and premature rupture of membranes, and correct abnormal fetal position promptly when it is found during labor and delivery.  2.Delivery care: instruct the mothers with high-risk factors of cord prolapse to rest in bed after delivery, carefully count fetal movement, closely observe the progress of labor, continuously monitor the fetal heart, and instruct them to adopt the head-low hip-high position if the fetal membranes rupture. If the umbilical cord prolapse is diagnosed, immediately adopt the knee-chest position, administer oxygen, and push up the fetal previa for those whose uterus is not fully opened, so as to reduce the pressure of the previa on the umbilical cord and restore the blood supply of the cord under pressure as much as possible. At the same time, immediately adopt cesarean section or vaginal assisted delivery.  3. Post-delivery care: (1) Prepare for neonatal asphyxia resuscitation; (2) Evaluate the degree of asphyxia and choose the appropriate resuscitation method until the newborn establishes breathing, turns red and cries loudly before ligating the umbilical cord; (3) Closely observe maternal contractions, prevent postpartum hemorrhage, promote maternal uterine contractions, and carefully check for soft birth canal lacerations, which must be sutured immediately if there are lacerations; (4) (4) For those who have perineal wounds, instruct the mother to lie on the healthy side to prevent the malodex from contaminating the wounds, keep the vulva clean and prevent infection; (5) Provide appropriate psychological guidance to the mother to calm her emotions.  Umbilical cord prolapse is a relatively rare obstetric complication, which can increase the mortality rate of perinatal infants if it is not detected and treated in time or treated improperly. Therefore, it is important to take timely and effective care measures.