What is the correct immediate action when faced with a prolapsed umbilical cord?

What is the correct immediate action when faced with a prolapsed umbilical cord?

• A. Place gloved fingers between the baby and the mother's pelvic bone
• B. Clamp and cut the cord and instruct the mother to push as hard as possible
• C. Insert gloved hand into the birth canal in order to restrain delivery
• D. Attempt to push the cord back into the birth canal

Answer: (A)

Relieving cord compression right away is the top priority. Inserting a gloved hand into the vagina to lift the presenting part off the cord prevents ongoing compression and preserves blood flow to the fetus while help is obtained. Keep the cord moist with sterile saline if possible, position the mother to reduce pressure on the cord (such as knee-chest or with hips elevated), and call for urgent obstetric support. Do not clamp or cut the cord now, do not push the cord back into the uterus, and do not urge the mother to push aggressively, as those actions can worsen compression and fetal well-being.

Relieving cord compression right away is the top priority. Inserting a gloved hand into the vagina to lift the presenting part off the cord prevents ongoing compression and preserves blood flow to the fetus while help is obtained. Keep the cord moist with sterile saline if possible, position the mother to reduce pressure on the cord (such as knee-chest or with hips elevated), and call for urgent obstetric support. Do not clamp or cut the cord now, do not push the cord back into the uterus, and do not urge the mother to push aggressively, as those actions can worsen compression and fetal well-being.