Which of the following sequences correctly describes recommended actions for a cord presentation?

• A. Clamp and cut the cord early
• B. Deliver the baby as quickly as possible without addressing the cord
• C. Position the patient in Trendelenburg and slightly to the left side; wrap cord and keep moist; insert gloved hand to lift the baby off the cord; obtain cord pulse
• D. Call for surgical intervention immediately

Answer: (C)

In a cord presentation, the priority is to relieve pressure on the umbilical cord and protect fetal perfusion while getting the patient to a facility capable of delivery. Positioning the patient in Trendelenburg with a slight left-side tilt uses gravity to shift the presenting part away from the cord, reducing compression. Keeping the cord wrapped in moist conditions preserves warmth and moisture to help maintain cord viability and perfusion to the fetus. Gently inserting a gloved hand to lift the baby off the cord directly relieves the compression, which is the most immediate way to prevent fetal compromise. If possible, note the presence of a cord pulse to assess ongoing perfusion.

These steps address the core threat: cord compression. Clamping and cutting the cord early would cut off placental support and worsen hypoxia. Delivering quickly without addressing the cord won’t relieve compression. Calling for surgical intervention right away isn’t something that can be carried out in the field; the EMS role is to support the mother and infant, relieve pressure, keep the cord viable, and expedite transport for definitive delivery.