Supplementary Material for: Intrapartum Point-of-Care Ultrasound (POCUS) may prevent cord prolapse in active labor: report of a case

Intrapartum point-of-care ultrasound (POCUS) is increasingly employed to assess fetal head position and labor progression. We describe a case in which intrapartum POCUS enabled the early detection of a compound cord presentation, preventing umbilical cord prolapse. A 33-year-old primigravida at 39+4 weeks in active labor showed a persistent right occiput posterior position with slow progress despite adequate contractions. After a failed manual rotation attempt transperineal ultrasound revealed a hypoechoic tubular structure lying between the fetal head and pubic symphysis, consistent with the umbilical cord. These sonographic findings suggested a compound cord presentation. An urgent Caesarean Section was performed, and a healthy male neonate weighing 3,700 g was delivered with Apgar scores of 9 and 10 and normal cord gases. Maternal recovery was uneventful. This case highlights the potential of intrapartum POCUS to identify rare, life-threatening conditions such as compound cord presentation, improving decision-making and preventing fetal hypoxia.