Question

A 25-year-old G1P0 woman at 38 weeks gestation presents to the ED after feeling a gush of fluid. On tocometry, you note late decelerations of the fetal heart rate. You perform a sterile vaginal exam and feel a pulsating mass protruding from the cervical os. Which of the following appropriately matches the diagnosis with the next step in management?

a) Breech positioning, attempt external version
b) Shoulder dystocia, knee-to-chest positioning
c) Umbilical cord prolapse, elevate presenting part
d) Uterine inversion, administer tocolytics

Answer 1

Umbilical cord prolapse requires immediate intervention, and the next step in management is to elevate the presenting part to relieve pressure on the cord.

Step-by-step explanation:

The diagnosis in this case is Umbilical cord prolapse. Umbilical cord prolapse occurs when the umbilical cord slips through the cervix and protrudes from the vaginal opening before the baby. It is a medical emergency that requires immediate intervention to prevent fetal distress or death. The next step in management for umbilical cord prolapse is to elevate the presenting part to relieve pressure on the cord and increase blood flow to the baby.