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1999 BMJ articel on cord prolapseFrom: Stmidwife@aol.comMon May 22 14:42:32 2006
El, how often is this done and is it still done? What to do with prolapsed pulsating umbilical cords 5 May 1999 Anne Seymour Send response to journal: Re: What to do with prolapsed pulsating umbilical cords EDITOR-I note from tomorrow's BMJ that patients still present with prolapsed pulsating cords in places where Caesarean section is not possible necessitating transfer of the patient. The article recommends the traditional methods of holding up the presenting part. In West Africa we have found the following method more successful. Pass a catheter and run in one bottle of intravenous saline (or if that is too expensive cooled boiled water). Disconnect the giving set and spigot the catheter. Most patients are very co-operative if they have been given a careful explanation of the procedure. As well as supporting the presenting part the full bladder tends to diminish contractions. Above all do not give up hope! Mama X went to her Traditional Birth Attendant (TBA) at 9pm. A prolapsed cord was found and acting on her protocol (she had done a six week course sponsored by Government and Mission) she referred Mama X to the Aid Post. Here the Nursing Aide (one year nursing course) acted on her instructions and referred Mama X to the Health Centre, having put a warm wet cloth and a pair of panties to protect the cord. At the Health Centre the Nurse /Midwife (three year course) referred her to the hospital. No one suggested the relatives carry her on a stretcher, so she walked. At 5am next morning she came into the maternity department by one door as I came in by the other. Leaving the labour ward nurse to get her ready I went to assemble the theatre staff. At 5.45am a healthy baby was born. Anne Seymour Retired Mission Doctor Harton House Rd South Shields 1 Geoffrey Chamberlain, Philip Steer ABC of labour care Unusual presentations and positions and multiple pregnancy BMJ1999 1 May 1192- 1194
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