Labour: cord prolapse: 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 · Labour: cord prolapse

Sample item

A multiparous woman at 38 weeks has a loop of pulsating cord visible at the vulva after spontaneous rupture of membranes, with the cervix 4 cm dilated. What is the best management?

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

The answer and the reasoning

D. Elevate the presenting part manually, place in knee-chest or Trendelenburg position and proceed to emergency caesarean section

Cord prolapse is an obstetric emergency. Compression of the cord by the presenting part is relieved by manual elevation, knee-chest position, bladder filling and tocolysis, while preparing for immediate caesarean section. Handling the cord minimally avoids spasm.

Option by option

  • A. Push the cord back into the uterus

    Replacing the cord is ineffective and wastes time.

  • B. Oxytocin augmentation

    Augmentation increases cord compression.

  • C. Wait for spontaneous vaginal delivery

    Waiting risks fetal hypoxia.

  • D. Elevate the presenting part manually, place in knee-chest or Trendelenburg position and proceed to emergency caesarean section (correct)

    Correct. Relieve compression and deliver urgently.

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, Elevate the presenting part manually, place in knee-chest or Trendelenburg position and proceed to emergency caesarean section. Cord prolapse is an obstetric emergency.

Why is "Push the cord back into the uterus" not the answer?

Replacing the cord is ineffective and wastes time.

Why is "Oxytocin augmentation" not the answer?

Augmentation increases cord compression.

Why is "Wait for spontaneous vaginal delivery" not the answer?

Waiting risks fetal hypoxia.

What concept does this question test?

It tests Labour: cord prolapse in OBG. Compression of the cord by the presenting part is relieved by manual elevation, knee-chest position, bladder filling and tocolysis, while preparing for immediate caesarean section. Handling the cord minimally avoids spasm.

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 Labour: cord prolapse?

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.