Question

Management of fetal distress during labor and delivery - cord prolapse

a. Elevate the mother's hips.

b. Administer tocolytic medications.

c. Perform a pelvic exam to reposition the cord.

d. Apply a fetal scalp electrode for continuous monitoring.

Answer 1

Management of fetal distress during labor and delivery - cord prolapse Perform a pelvic exam to reposition the cord. Thus, the correct option is c. Perform a pelvic exam to reposition the cord.

Step-by-step explanation:

In cases of cord prolapse during labor and delivery, the most appropriate course of action is to perform a pelvic exam to reposition the cord. This involves gently pushing the presenting part of the fetus off the prolapsed cord and then elevating the fetal presenting part to relieve pressure on the cord. This maneuver helps to restore blood flow to the fetus and prevents further complications. Elevating the mother's hips (option a) may be a part of the repositioning process, but it alone is not sufficient. Administering tocolytic medications (option b) may be used in some situations to delay delivery and provide time for intervention, but it is not the primary action for cord prolapse. Applying a fetal scalp electrode for continuous monitoring (option d) is not the first-line intervention for cord prolapse but may be considered after the cord is successfully repositioned to monitor the fetal heart rate more closely.

Prompt and appropriate management of cord prolapse is crucial to prevent fetal distress and ensure a favorable outcome. Performing a pelvic exam allows the healthcare provider to manually correct the cord's position, alleviating the compression and restoring blood flow to the fetus. The goal is to expedite delivery while minimizing risks to both the mother and the baby. It's essential for healthcare professionals to be trained in these maneuvers to act promptly and effectively in emergency situations, emphasizing the significance of continuous monitoring and quick decision-making in obstetric care.

Therefore, the correct option is c. Perform a pelvic exam to reposition the cord.

Answer 2

In the management of fetal distress during labor and delivery with cord prolapse, the appropriate action is option (a): Elevate the mother's hips.

Step-by-step explanation:

Elevating the mother's hips is a critical intervention in the case of cord prolapse. This action helps alleviate pressure on the umbilical cord, preventing compression and ensuring continued blood flow to the fetus. By placing the mother in a Trendelenburg or knee-chest position, gravity assists in relieving pressure on the prolapsed cord, offering a temporary solution while further steps are taken to address the situation.

Performing a pelvic exam to reposition the cord or applying a fetal scalp electrode for continuous monitoring may not be the initial priorities in cord prolapse cases. Administering tocolytic medications (option b) could be considered to reduce uterine contractions, but the primary concern in cord prolapse is the immediate relief of pressure on the cord. Elevating the mother's hips is a time-sensitive measure that can significantly impact fetal well-being during this emergency situation.

In summary, the decision to elevate the mother's hips is based on the understanding that prompt action is needed to alleviate pressure on the prolapsed cord and maintain fetal perfusion. This intervention is in line with established guidelines for managing cord prolapse during labor and underscores the importance of quick, effective responses in emergency obstetric situations.