Which statement accurately describes the sequence of steps for cord prolapse management?

• A. Place knee-chest position, then manual relief
• B. Manual relief, then knee-chest
• C. Administered terbutaline
• D. Administered nifedipine

Answer: (B)

In cord prolapse, the highest priority is to relieve the cord compression to protect the fetus. The first step is to manually displace the presenting part off the cord, using sterile technique if possible, to relieve the pressure on the cord. Once the cord is relieved, place the patient in a knee-chest position (or another position that elevates the hips and relieves pressure) to further reduce ongoing compression and improve uteroplacental perfusion while preparing for delivery. Medications to relax the uterus, like terbutaline or nifedipine, are not the initial actions in this acute sequence because they don’t relieve cord compression and should not precede manual relief. The aim is to stabilize the situation and expedite delivery.