Which condition occurs when the umbilical cord is positioned ahead of the baby during delivery?

• A. Nuchal Cord
• B. Placenta Previa
• C. Ectopic Pregnancy
• D. Prolapsed Cord

Answer: (D)

Prolapsed umbilical cord happens when the cord slips down into the birth canal ahead of the presenting part. The cord can then be compressed by contractions or by the baby’s movement, which can cut off or lessen blood flow and oxygen to the fetus. Because the fetus depends on the cord for oxygen during birth, this is an emergency that demands immediate action to relieve pressure on the cord and to deliver the baby promptly.

This situation is different from a nuchal cord, where the cord loops around the baby’s neck; from placenta previa, where the placenta covers the cervix and causes bleeding rather than cord compression; and from an ectopic pregnancy, where implantation occurs outside the uterus. In a prolapsed cord, the key issue is that the cord is in front of the presenting part and at risk of rapid compression during labor, not merely its location around the fetus or placenta location.

In practice, the priority is to relieve cord compression and expedite delivery. Gently elevate the presenting part and keep the cord from being compressed, position the mother in a way that reduces pressure on the cord (often knee-chest or Trendelenburg with hips up), administer oxygen, establish IV access, and call for help to enable rapid delivery, typically by cesarean section if time and fetal status require it, or a rapid vaginal delivery if feasible. After delivery, the cord is clamped and cut as part of standard care.