During labor, crowning with a loop of umbilical cord protruding, which action should you take immediately?

During labor, crowning with a loop of umbilical cord protruding, which action should you take immediately?

• A. Call EMS only
• B. Push the cord back in
• C. Have the woman assume a knee-chest position
• D. Wait for further contractions

Answer: (C)

A loop of umbilical cord protruding during labor signals a prolapsed cord, a true obstetric emergency because the cord can be compressed and cut off the fetus’s oxygen supply. The immediate action is to relieve that compression right away. Having the mother assume a knee-chest position changes the angle of the uterus and presents part, lifting pressure off the cord and increasing blood flow to the baby until help arrives. This position buys critical time and reduces the risk of fetal hypoxia. Pushing the cord back in is not advised because it can worsen compression and delay proper care. Waiting for further contractions does not address the immediate danger. If possible while maintaining the position, you can gently elevate the presenting part and keep the cord moist, but prioritize getting EMS on the way.

A loop of umbilical cord protruding during labor signals a prolapsed cord, a true obstetric emergency because the cord can be compressed and cut off the fetus’s oxygen supply. The immediate action is to relieve that compression right away. Having the mother assume a knee-chest position changes the angle of the uterus and presents part, lifting pressure off the cord and increasing blood flow to the baby until help arrives. This position buys critical time and reduces the risk of fetal hypoxia.

Pushing the cord back in is not advised because it can worsen compression and delay proper care. Waiting for further contractions does not address the immediate danger. If possible while maintaining the position, you can gently elevate the presenting part and keep the cord moist, but prioritize getting EMS on the way.