On fetal heart tracing (a linear recording of the fetal heart rate) this would usually look like moderate to severe variable decelerations. In overt cord prolapse, the cord can be seen or felt on the vulva or vagina.A majority of umbilical cord prolapse cases happen during the second stage of labor. Risk factors
Risk factors that are associated with umbilical cord prolapse tend to make it difficult for the baby from appropriately engaging and filling the maternal pelvis or are related to abnormalities of the umbilical cord. The two major categories of risk factors are spontaneous and iatrogenic (those that result from medical intervention). spontaneous factors:
fetal malpresentation: abnormal fetal lie tends to result in space below the baby in the maternal pelvis, which can then be occupied by the cord. polyhydramnios, or an abnormally high amount of amniotic fluid
prematurity: likely related to increased chance of malpresentation and relative polyhydramnios. low birth weight: usually described as <2500g at birth, though some studies will use <1500g. Cause is likely similar to those for prematurity. multiple gestation, or being pregnant with more than one baby at a given time: more likely to occur in the baby that is not born first. spontaneous rupture of membranes: about half of prolapses occur within 5 minutes of membrane rupture, two-thirds within 1 hour, 95% within 24 hours.
Pupillary hippus, also known as pupillary athetosis, is spasmodic, rhythmic, but regular dilating and contracting pupillary movements between the sphincter and dilator muscles. Pupillary hippus comes from the Greek hippos meaning horse, perhaps due to the rhythm of the contractions representing a galloping horse.It is particularly noticeable when pupil function is tested with a light, but is independent of eye movements or changes in illumination. It is usually normal, however pathological hippus can occur.Pathologic hippus, the phenomenon of increased oscillation or their amplitude, is associated with aconite poisoning, altered mental status, trauma, cirrhosis, and renal disease; suggesting a common pathway of frontal lobe dysfunction. A retrospective study of 117 hospitalized patients with hippus noted an increased 30-day mortality when compared to controls and adjusted for other factors. See also
Athetosis
Anisocoria - condition characterized by an unequal size of the eyes pupils. == References ==