Cord prolapse is often associated with abnormal fetal heart rate tracings due to the compression of the umbilical cord. They can present with fetal heart rate changes, such as variable decelerations with contractions that return to baseline, prolonged or severe decelerations. High suspicion of cord prolapse, with non-reassuring fetal heart rate tracings should prompt delivery via cesarean section regardless of findings on vaginal exam.
A palpable cord may be found on a vaginal exam if a patient is presenting with spontaneous rupture of membranes, or may occur during an artificial rupture of membranes. It will feel like a pulsatile mass either between the fetal presenting part or alongside the presenting part.