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Suspected uterine rupture — DRCOG MCQ

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HardLabourSuspected uterine ruptureDRCOG

Following rupture of membranes in labour, a woman develops sudden fetal bradycardia and the umbilical cord is palpable below the presenting part. What is the most appropriate management?

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Correct answer: A — Call obstetric emergency, elevate presenting part and expedite birth

The best answer is “Call obstetric emergency, elevate presenting part and expedite birth”. A palpable cord with fetal bradycardia is cord prolapse and requires immediate obstetric emergency management. Relieving cord compression by elevating the presenting part and positioning the woman appropriately occurs while arrangements are made for urgent birth. Oxytocin, delayed imaging and continued observation worsen the risk of fetal hypoxia.

Reference: NICE NG235: Intrapartum care: https://www.nice.org.uk/guidance/ng235/chapter/Recommendations