If it still pulsates, the woman should be placed in the knee-chest position for ten or fifteen minutes, then upon the side, opposite to that on which the cord has prolapsed, and back again as soon as possible to the knee-chest position. A chair may be used to produce a Trendelenburg position by placing it so that the edge of seat and top of back rest on the bed. Then the patient puts her legs over the lower rungs and lies with her back against the chair back and her head on the bed.
If the cervix is effaced and the os partly dilated, reposition may be attempted either with the finger or a male catheter.
The operation will, of course, succeed most easily if done in the knee-chest position, with gravity to aid.
If the cord can be pushed back, a Vorhees bag may be inserted to keep it from coming down again. This holds back the cord, dilates the canal and stimulates the pains.
When the bag comes out, version and extraction can and should be done at once.
In general, the following summary may be useful:
Prolapse of Cord
Causes.—
Contracted pelves.
Breech and transverse presentations.