امرأة حامل في الأسبوع ٣٨، أثناء المخاض انفجر الكيس، وبعدها مباشرة نزل نبض الجنين إلى ٧٠ ولم يرجع، وتحس الممرضة بالحبل السري في المهبل. ما أول إجراء؟

A woman at 38 weeks in labour has spontaneous rupture of membranes, immediately followed by fetal heart rate 70 that does not recover; the nurse feels the cord in the vagina. What is the first action?

1. Encourage strong pushing to finish the birth quickly
2. Lift the presenting part off the cord, knee-chest, call for help
3. Gently pull the cord out to relieve pressure on it
4. Give oxytocin to strengthen contractions and speed the delivery now

Answer: B) Lift the presenting part off the cord, knee-chest, call for help. Cord prolapse is an emergency: lift the presenting part off the cord, position knee-chest or Trendelenburg, give oxygen and prepare for emergency caesarean. Minimise handling and never pull the cord.