What should be done for a prolapsed cord during delivery?

• A. Elevate the mother's hips and place her in a knee-to-chest position
• B. Administer oxygen
• C. Push the presenting part back toward the uterus
• D. Apply external pressure to the cord

Answer: (A)

Prolapsed cord is an obstetric emergency because the cord can be compressed by the presenting part, cutting off fetal oxygen. The immediate aim is to relieve that compression as quickly as possible. Elevating the mother’s hips and placing her in a knee-to-chest position uses gravity to shift the uterus away from the cord and gives the presenting part less opportunity to press on it, which can restore or improve blood flow to the fetus while preparing for delivery. Oxygen for the mother may be used as an adjunct, but it does not remove the physical compression. Pushing the presenting part back toward the uterus is unsafe because it can push the cord back into a position of greater compression or cause trauma. Applying external pressure to the cord is also dangerous and should be avoided; if feasible, a clinician may gently elevate the presenting part with a gloved hand to relieve pressure while arranging for urgent delivery.