A 40-year-old woman in 3 weeks of gestation with polyhydramnios presented in active labor following spontaneous rupture of membranes. Cardiotocogram shows persistent fetal bradycar... A 40-year-old woman in 3 weeks of gestation with polyhydramnios presented in active labor following spontaneous rupture of membranes. Cardiotocogram shows persistent fetal bradycardia. Which of the following is the most likely diagnosis? A. Cord prolapse B. Rapid fetal descent C. Placental insufficiency D. Congenital heart abnormalities
Understand the Problem
The question describes a pregnant woman with polyhydramnios presenting in active labor with fetal bradycardia. We need to determine the most likely diagnosis from the given options: umbilical cord prolapse, rapid fetal descent, placental insufficiency, or congenital heart abnormalities. The key here is to identify which condition is most acutely associated with sudden fetal bradycardia during labor, especially in the context of polyhydramnios and membrane rupture.
Answer
Cord prolapse
The final answer is Cord prolapse
Answer for screen readers
The final answer is Cord prolapse
More Information
In obstetric practice, the presence of polyhydramnios, spontaneous rupture of membranes, and persistent fetal bradycardia often suggests cord prolapse. Cord prolapse occurs when the umbilical cord slips ahead of the presenting part of the fetus and becomes compressed, leading to decreased blood flow and oxygen to the fetus.
Tips
A common mistake is to confuse cord prolapse with placenta issues due to similar symptoms. Check for physical cord presentation or changes in fetal heart metrics to confirm.
Sources
- Fetal Compromise in Labor - cambridge.org
- Day 7 Obstetrics Flashcards by Samuel Goundry | Brainscape - brainscape.com
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