Cord prolapse — DipIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesCord prolapseDipIMC

A labouring woman’s membranes rupture in the ambulance and a cord is visible at the vulva. Fetal movements were present moments earlier. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Relieve cord compression and transfer urgently

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as E

D is correct: Cord prolapse threatens fetal oxygenation; relieving compression and urgent obstetric care are priorities. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because it does not address the discriminator in the vignette; C is less suitable because analgesia is important but does not replace the first physiological intervention; E is less suitable because it delays the immediate life-saving step in the cABCDE sequence. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; Resuscitation Council UK Paediatric and Newborn Guidelines; NICE NG39