Cord pn+vasa praevia+afe

OBG

1. CORD PROLAPSE & CORD PRESENTATION

2. DEFINITION: Abnormal descent of the umbilical cord by the side of presenting part is called as Cord prolapse . TYPES: Occult prolapse : here cord is placed by side of presenting part but is not felt on doing int. exam. Cord presentation: here cord is slipped down below the presenting part & is felt lying in the intact bag of membranes. Cord prolapse : cord is lying inside the vagina or outside the vulva following ROM

3. Occult Prolapse Cord presentation Cord Prolapse

4. INCIDENCE: 1 in 300 deliveries More common in parous women ETIOLOGY: Malpresentations Contracted pelvis Prematurity Multiple gestation Hydramnios Minor degree of Placenta praevia /marginal insertion of cord / long cord Iatrogenis -LROM, version.

5. DIAGNOSIS: Occult prolapse : is difficult to diagnose Cord presentation: feeling the pulsation of cord through intact membranes Cord prolapse : direct visualization or its palpation & feeling of its pulsation

6. MANAGEMENT (schematic mngt )

7. VASA PRAEVIA

8. INTRODUCTION Vasa praevia  is defined as "fetal vessels crossing or running in close proximity to the inner  os .” These vessels course within the membranes & are at risk of rupture when the supporting membranes rupture.

9. INCIDENCE: It is most commonly associated with: Velamentous insertion of cord, multiple gestation, succenturiate lobe of placenta MANAGEMENT: Immediate vaginal delivery or CS Check fetal blood studies Start blood transfusion immediately. Continuous monitoring of newborn & mother.

10. AMNIOTIC FLUID INDEX: Amniotic fluid embolism  is a rare obstetric emergency in which  amniotic fluid enters the mother's blood stream via a rent in the membranes or placenta which results in cardio-respiratory collapse and DIC. CAUSE: ruptured membranes, procedures like amniocentesis, etc. FEATURES: Dyspnea , hypotension, respiratory arrest, cardiac arrest. TREATMENT: Emergency CS.

11. Thank you..!!