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Umbilical cord prolapse — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesUmbilical cord prolapseDIPIMCDipIMC

After membrane rupture at home, a loop of umbilical cord is visible and the fetal heart is profoundly bradycardic. Emergency obstetric transfer is ready. What immediate action best protects fetal oxygenation?

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

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Correct answer: B — Elevate the presenting part, position to reduce compression and expedite transfer

The best answer is “Elevate the presenting part, position to reduce compression and expedite transfer”. Umbilical cord prolapse with fetal bradycardia requires immediate relief of compression while expediting birth. Manually elevate the presenting part if trained, use knee-chest or a lateral head-down position, minimise cord handling and keep an exposed cord warm and moist. Replacing, clamping or compressing the cord can worsen fetal hypoxia; transfer must proceed to urgent obstetric intervention.

Reference: RCOG Green-top Guideline 50, Umbilical cord prolapse: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/umbilical-cord-prolapse-green-top-guideline-no-50/