What are the indications for urgent referral to obstetrics in cases of cord prolapse?

Indications for urgent referral to obstetrics in cases of umbilical cord prolapse include:

• Any suspicion or confirmation of umbilical cord prolapse during labour or after membrane rupture requires immediate obstetric referral due to the risk of fetal hypoxia and compromise.
• Precautions to avoid cord prolapse include assessing the fetal head position and stability before induction of labour and careful vaginal examination to avoid dislodging the presenting part, highlighting the critical nature of cord prolapse as an obstetric emergency.
• Continuous cardiotocography (CTG) monitoring is recommended after membrane rupture if the presenting part is not well applied to the cervix, as this may indicate risk of cord prolapse and fetal compromise, necessitating urgent obstetric intervention.
• Urgent referral is warranted when there is evidence of fetal compromise or abnormal CTG patterns associated with cord prolapse.

In summary, any clinical suspicion or diagnosis of umbilical cord prolapse, especially following membrane rupture and unstable fetal head presentation, mandates urgent referral to obstetrics for immediate assessment and management to prevent adverse fetal outcomes ¹.