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Cord prolapse in the community — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesCord prolapse in the communityDipIMC

A 28-year-old at 39 weeks' gestation has ruptured membranes at home and feels something in the vagina. You see a pulsating umbilical cord, fetal movements are reduced and contractions continue every 3 minutes. What is the most appropriate management?

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

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Correct answer: C — Relieve cord compression with maternal positioning and urgent obstetric transfer

Cord prolapse requires urgent transfer while reducing compression, commonly with knee-chest or left lateral positioning and manual elevation of the presenting part if trained. Replacing the cord is not recommended because it can cause vasospasm and delay. Clamping the cord before birth would be catastrophic for the fetus.

Reference: JRCALC maternity guidance; RCOG cord prolapse guidance