Monday, January 18, 2016

Hold It Up

This ultrasound is from a G4P2 woman presenting with transverse lie. The infant is 32 weeks gestation with low birth weight. The patient had spontaneous rupture of membranes just half an hour ago. You are called emergently by the obstetrical nurse because of a sudden, severe, prolonged fetal bradycardia. On manual examination, you make the diagnosis.

Challenge: What are you most worried about?


RaH said...

ablatio placentae?

Craig Chen said...

good thought - abruption is definitely on the differential
Hold It Up

Umbilical cord prolapse is an obstetrical emergency when the umbilical cord descends alongside or beyond the fetal presenting part; fetal blood flow is usually compromised. The immediate management involves manually elevating the presenting part. The ultrasound shows umbilical cord (colorflow Doppler) just above the cervical canal.

Source: UpToDate.