أثناء المخاض انفجر كيس الماء، ورأت الممرضة الحبل السري ظاهراً من المهبل. ما الإجراء الصحيح؟

During labour the membranes rupture, and the nurse sees the umbilical cord protruding from the vagina. What is the correct action?

1. Lay her flat on her back and wait for the provider
2. Gently push the cord back into the vagina with a sterile hand
3. Ask her to push hard to speed the baby’s delivery
4. Lift the presenting part off the cord; knee-chest

Answer: D) Lift the presenting part off the cord; knee-chest. Cord prolapse is an emergency because the presenting part compresses the cord and cuts off oxygen. The nurse lifts the presenting part off it with a sterile hand and places the mother knee-chest or Trendelenburg while help is summoned for urgent caesarean. The cord is not replaced because handling causes vasospasm, and pushing or lying flat increases compression.