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Umbilical cord prolapse — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesUmbilical cord prolapseDIPIMCDipIMC

A woman in advanced labour has spontaneous rupture of membranes, and you see a loop of umbilical cord at the introitus. The cord is pulsating. What is the most appropriate immediate management?

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Correct answer: C — Place her knee-chest, relieve cord pressure, and transfer urgently

Cord prolapse is an obstetric emergency, and the aim is to relieve pressure on the cord by positioning the mother knee-chest or in an exaggerated left-lateral position with the hips elevated, handling the cord as little as possible to avoid vasospasm, while transferring urgently for delivery. Attempting to replace the cord or clamping it is harmful, and fundal pressure or sitting upright worsens cord compression. Pearl: manually elevating the presenting part, or filling the bladder, can further reduce cord compression during transfer.

Reference: MBRRACE-UK; JRCALC Clinical Guidelines