Procidence of the cord
Definition
Procubitus
The presence of a cord in front of the presentation takes the name of procubitus when the pocket of water is intact.
Procidence
The presence of a cord in front of the presentation takes the name of procidence when the pocket of water is broken.
Risk factors of procidence
- All the situations leading to a bad accommodation enters the presentation and the maternal basin
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Excés of amniotic liquid
Présentation of the seat Placenta praevia membrane Rupture on a high presentation
Prevention
Before breaking the membranes artificially, the midwife must check the absence of procubitus cord. This membrane rupture will have to be carried out on a presentation at least actually applied to the higher strait, decreasing the risk which the cord comes to interpose between the head and outside. The membrane rupture will have to be careful in the event of excess of known liquid, preferably with the needle to avoid a liquid rout in which the cord is likely to be transported.
Action to be taken
Procubitus
The presence of a procubitus of the cord imposes the Cesarean in urgency.
Procidence
The cord goes down then in the Vagin by the collar, and is found seriously compressed between the bones of the maternal basin and the bones of fetal cranium. It is an extremely serious accident, involving most of the time a fetal Souffrance acute major.
Although in the large majority of the cases the Cesarean in extreme urgency is essential, a childbirth by low way is possible in the event of podalic presentation with complete or cephalic dilation with complete dilation with instrumental extraction of the fetus. The passage in room of Cesarean should suffer from no delay, and the most experienced midwife (oldest of the team) will carry out the manual repression of the presentation until the extraction by Cesarean.