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Cord prolapse — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesCord prolapseDipIMC

A woman at 39 weeks has ruptured membranes at home and a loop of umbilical cord is visible at the introitus. Contractions continue. What is the most appropriate immediate action?

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

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Correct answer: A — Minimise cord compression with maternal positioning and urgent obstetric transfer

Option A is correct because Cord prolapse threatens fetal oxygenation; reducing compression and rapid transfer for delivery are priorities. Option D is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option C is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option B is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option E is less appropriate because delay would increase clinical risk. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines; RCOG cord prolapse guidance