Emergency measures used in the treatment of a prolapsed cord include which of the following? (Select all that apply.)
a. Administration of oxygen via face mask at 8 to 10 L/min
b. Maternal change of position to knee-chest
c. Administration of tocolytic agent
d. Administration of oxytocin (Pitocin)
e. Vaginal elevation
f. Insertion of cord back into vaginal area
ANS: A, B, C, E
Prolapsed cord is a medical emergency. Oxygen should be administered to the mother to increase perfusion from mother to fetus. The maternal position change to knee-chest or Trendelenburg to offset pressure on the presenting cord should be done. A tocolytic drug such as terbutaline inhibits contractions, increasing placental blood flow and reducing intermittent pressure of the fetus against the pelvis and cord. Vaginal elevation should be done to offset pressure on the presenting cord. Pitocin and manipulation of the cord by reinsertion are contraindicated.
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