Cord presentation and cord prolapse

1. Big picture

Umbilical cord prolapse is an acute obstetric emergency. It occurs when the umbilical cord descends below or beside the presenting part after rupture of membranes, causing cord compression and rapid fetal hypoxia.

The examiner wants you to say immediately:

Call for help, relieve cord compression, and expedite delivery.

The clinical pattern is classic:

Rupture of membranes
      ↓
Sudden fetal bradycardia or severe variable decelerations
      ↓
Cord seen or felt in vagina
      ↓
Manual elevation of presenting part + knee-chest/left lateral position
      ↓
Emergency delivery, usually caesarean section

This is not a diagnosis where you “observe and wait” if the fetus is viable.

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