Normal pregnancy: nuchal cord: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Normal pregnancy: nuchal cord

Sample item

A 39-week fetus is found to have a single loose loop of cord around the neck at delivery, with a reassuring heart rate throughout. What is the recommended management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Slip the loop over the head or deliver through it, and do not clamp routinely before delivery of the body

Nuchal cord is present in about a quarter of deliveries and usually causes no harm. A loose loop is slipped over the head, and a tight loop may be gently clamped and cut or the shoulders delivered by the somersault manoeuvre. Routine clamping before delivery of the shoulders is not recommended.

Option by option

  • A. Perform an emergency caesarean section

    Caesarean is not indicated for an isolated nuchal cord.

  • B. Do nothing and prevent any cord handling for 5 minutes

    Doing nothing is not suitable when the loop might impede delivery.

  • C. Clamp and cut the cord immediately in all cases

    Immediate clamping in every case is unnecessary.

  • D. Slip the loop over the head or deliver through it, and do not clamp routinely before delivery of the body (correct)

    Correct. Loose loops are slipped over the head, and clamping is reserved for tight loops.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Slip the loop over the head or deliver through it, and do not clamp routinely before delivery of the body. Nuchal cord is present in about a quarter of deliveries and usually causes no harm.

Why is "Perform an emergency caesarean section" not the answer?

Caesarean is not indicated for an isolated nuchal cord.

Why is "Do nothing and prevent any cord handling for 5 minutes" not the answer?

Doing nothing is not suitable when the loop might impede delivery.

Why is "Clamp and cut the cord immediately in all cases" not the answer?

Immediate clamping in every case is unnecessary.

What concept does this question test?

It tests Normal pregnancy: nuchal cord in OBG. A loose loop is slipped over the head, and a tight loop may be gently clamped and cut or the shoulders delivered by the somersault manoeuvre. Routine clamping before delivery of the shoulders is not recommended.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Normal pregnancy: nuchal cord?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.