A 30-year-old G2P1 at 39 weeks is in active labour (6 cm) with oxytocin augmentation. CTG suddenly shows prolonged deceleration to 70 bpm lasting 4 minutes. On examination the cervix is 6 cm and the cord is palpated below the presenting part. Immediate action is:
- A Manual elevation of the presenting part, call for emergency cesarean ✓
- B Lateral decubitus positioning and increase oxytocin
- C Apply Wrigley forceps and deliver immediately
- D Intrauterine oxygen via amniotic fluid infusion
Correct answer: A. Manual elevation of the presenting part, call for emergency cesarean
Explanation
Cord prolapse with a viable fetus requires immediate relief of cord compression by manually elevating the presenting part per vaginam while simultaneously preparing for emergency cesarean delivery. Oxytocin must be stopped. Forceps delivery is not feasible at 6 cm dilation. Amniotic infusion may help relieve variable decelerations due to cord compression in intact membranes but is not the primary management for overt prolapse.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.