During labor, which action is most appropriate when the umbilical cord is seen protruding from the vagina and the membranes have ruptured?

• A. Administer 100% oxygen.
• B. Place the patient in Trendelenburg position.
• C. Place the patient in a knee-chest position.
• D. Call for emergency cesarean delivery immediately.

Answer: (C)

Relieving cord compression is the immediate priority when a prolapsed umbilical cord is seen after the membranes rupture. The knee-chest position uses gravity to shift the uterus and presenting part away from the cord, reducing pressure on the cord and helping to preserve fetal oxygenation while delivery is arranged. This quick maneuver directly addresses the cause of potential fetal hypoxia and buys time for definitive delivery, typically by emergency cesarean. If feasible, one can gently elevate the presenting part with a sterile gloved hand to further relieve pressure, without pushing the cord back. Oxygen might be used as a supportive measure, but it doesn’t resolve the compression and isn’t the primary action.