When variable decelerations suggesting cord compression are observed, what action should be taken immediately?

When variable decelerations suggesting cord compression are observed, what action should be taken immediately?

• A. Notify the nurse-midwife or health care provider
• B. Perform a vaginal examination
• C. Insert a gloved finger into the vagina to feel for cord compression
• D. Position the mother so that her hips are elevated

Answer: (D)

Relieving pressure on the umbilical cord is the immediate priority when fetal heart rate patterns indicate cord compression. Positioning the mother with the hips elevated or shifting to a side-lying position helps move the uterus off the cord, improving placental blood flow and fetal oxygenation right away. After repositioning, alert the nurse–midwife or provider and continue close fetal monitoring, with the option to administer oxygen and reassess or adjust labor management as needed. Procedures like a vaginal examination or finger-checking for cord sensation aren’t the immediate action to relieve compression and can risk introducing or worsening complications; they don’t provide the rapid relief the fetus needs in this moment.

Relieving pressure on the umbilical cord is the immediate priority when fetal heart rate patterns indicate cord compression. Positioning the mother with the hips elevated or shifting to a side-lying position helps move the uterus off the cord, improving placental blood flow and fetal oxygenation right away. After repositioning, alert the nurse–midwife or provider and continue close fetal monitoring, with the option to administer oxygen and reassess or adjust labor management as needed. Procedures like a vaginal examination or finger-checking for cord sensation aren’t the immediate action to relieve compression and can risk introducing or worsening complications; they don’t provide the rapid relief the fetus needs in this moment.