Immediately after artificial rupture of membranes in a multipara at 8 cm dilation, the umbilical cord is palpated in the vagina alongside the presenting part. The fetal heart shows severe bradycardia. The operating theater needs 15 minutes to be ready. What should be done while preparing for delivery?
- A Push the cord back into the uterus and continue labour
- B Attempt immediate vacuum extraction on the ward
- C Manually elevate the presenting head off the cord, knee-chest position, and continuous cord monitoring ✓
- D Give a tocolytic and wait for spontaneous vaginal delivery
Correct answer: C. Manually elevate the presenting head off the cord, knee-chest position, and continuous cord monitoring
Explanation
Cord prolapse with a live fetus demands relieving compression until cesarean: manual elevation of the presenting part off the cord, knee-chest or exaggerated Sims position, bladder filling if needed, and avoidance of handling the cord itself. Pushing the cord back risks vessel spasm, and instrumental delivery takes longer than cesarean from this station. Delivery should occur within roughly 30 minutes of diagnosis.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.