Umbilical cord prolapse occurs after spontaneous rupture of membranes. What should the nurse do immediately?

• A. Apply oxygen via mask and call for help.
• B. Place the client in a knee-chest position.
• C. Immediately deliver via cesarean.
• D. Place the client in a Trendelenburg position.

Answer: (D)

Umbilical cord prolapse is an obstetric emergency because the cord can be compressed by the presenting part after the membranes rupture, leading to fetal hypoxia. The immediate goal is to relieve that compression while arranging for rapid delivery. Placing the patient in a Trendelenburg position—the body tilted so the head is lower than the feet—uses gravity to shift the uterus and presenting part away from the cord, reducing pressure on the cord and improving placental perfusion long enough to expedite delivery. While awaiting delivery, avoid touching or pushing on the cord, keep the cord moist if exposed, monitor fetal status, and call for help. Providing oxygen to the mother can support fetal oxygenation, but the first action to take is repositioning to relieve compression.