In the management of umbilical cord prolapse, which action is the initial maneuver?

• A. Place knee-chest position
• B. Administered terbutaline
• C. Administered nifedipine
• D. Manually relieve cord compression

Answer: (D)

Relieving cord compression right away is the priority. In umbilical cord prolapse, the cord can be squeezed by the presenting part, cutting off fetal blood flow. The first action is to insert a sterile gloved hand into the vagina and gently lift the presenting part away from the cord to relieve the pressure. This manual elevation buys time to restore blood flow and stabilize the fetus while arranging delivery. Keep the cord moist with sterile saline-soaked gauze, and call for help immediately. After manual relief, position the mother to further reduce pressure on the cord and prepare for delivery. Tocolytics like terbutaline or nifedipine are not the initial maneuver for this situation.