4 Prolapsed cord-การวินิจฉัย visualization or palpation of the umbilical cord ahead of the presenting part.occult umbilical cord prolapse is based on the abrupt onset of severe, prolonged fetal bradycardia or moderate to severe variable decelerations in a patient with a previously normal tracing
9 Iatrogenic factors ●Iatrogenic rupture of membranes , especially with an unengaged presenting part●Cervical ripening with a balloon catheter●Induction of labor
10 Iatrogenic factors ●Application of an internal scalp electrode ●Insertion of an intrauterine pressure catheter●Manual rotation of the fetal head
11 Iatrogenic factors ●Amnioinfusion ●External cephalic version ●Internal podalic version●Application of forceps or vacuum
12 Pre-hospital cord prolapse Women with an overt cord prolapse should call for help and assume the knee-chest face-down position
13 During ambulance transfer, a left lateral position is advised, with pillows under the hip. If possible, the presenting part should be elevated manually or by bladder distension during the transfer
14 Pregnancies with funic presentation follow-up evaluation of cord locationUntil cervix 2 cms 90% induction of labor by “needling” the membranes in a controlled environment, with the anesthesia team ready for an emergency cesarean delivery in the event of cord prolapse.