I got this question on cord prolapse during my final professional semester exam last year. Unfortunately I screwed it up. However, I realize that it is an unforgiven mistake for any medical students – who will eventually become a doctor – for not knowing much about cord prolapse when the condition is one of the obstetric emergency. Being not able to diagnose and manage the condition accordingly must be considered as a big sin!

What is cord prolapse?

This is exactly the first question that we need to ask ourselves. If we do not know this, we will not able to answer the rest of questions regarding this matter.

Cord prolapse or presentation of the cord is the condition when the cord (thing that connect the placenta and the fetus) is presented below the presenting part. There are two types of cord prolapse.

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Back in February 2008, during my final professional examination for semester 7, I encounter this one obstetrics station during my Objectives Structured Practical Examination (OSPE) paper. I have been given a thing, looks like a transparent plastic straw, with some curly thing inside it. The length is about 30cm. At one end of the straw, I can see that it is thin and sharp. The plastic straw is not hard but not soft either. Suffice to say that it is fairly flexible.

Based on my limited experience, I know that I do not know what that thing is. It looks like an amniotic hook for me but I know that it is not. During my obstetrics posting, I have been assigned to the labor room for a week, but I never encounter any doctors or medical staffs using it (or may be they used it when I was not there).

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First of all, bear in mind that like in any other physical examination, it is compulsory that we start with general examination before proceed to regional examination. Same goes here in abdominal examination on the pregnant mother. Some of us might too keen to touch the distended abdomen of the mothers and miss the general examination part. It happened to me once, during my final professional examination in the long Objective Structured Clinical Examination (OSCE) station and fair enough, I failed in that station.

Well.. Anything can happen when you are panicking. The key point is, always try to calm down. At the end of the day, it is the quality that you need to be an excellent doctor.

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