The nurse recognizes that which fetal presentation increases a patient’s risk for umbilical cord prolapse? (Select all that apply).

The correct answer is choice B, C, D and E.These are all fetal presentations that increase a patient’s risk for umbilical cord prolapse.Umbilical cord prolapse is when the umbilical cord comes out of the uterus with or before the presenting part of the baby.This can cause fetal hypoxia and brain damage due to cord compression.

Choice A is wrong because vertex presentation is the most common and normal fetal position, where the head is down and fully flexed.

This does not increase the risk of cord prolapse.

Normal ranges for fetal presentation are:

• Vertex: 95% of term deliveries.

• Breech: 3% to 4% of term deliveries.

• Transverse lie: 0.5% of term deliveries.

• Face: 0.2% of term deliveries.

• Brow: 0.1% of term deliveries.

The correct answer is choice C.“I will come to the hospital as soon as my water breaks.” This statement indicates understanding of measures to prevent umbilical cord prolapse, which is a complication that occurs when the umbilical cord drops out of the cervix before the baby during labor.This can cut off the baby’s blood and oxygen supply and cause permanent brain damage.Immediate delivery by C-section is usually necessary.

Choice A is wrong because squatting or sitting on hard surfaces does not increase the risk of umbilical cord prolapse.

Choice B is wrong because decreased fetal movement is not a sign of umbilical cord prolapse, but rather a sign of fetal distress that may have other causes.

Choice D is wrong because drinking plenty of fluids and resting on the left side are general measures to promote maternal and fetal well-being, but they do not prevent umbilical cord prolapse.

Some of the risk factors for umbilical cord prolapse include premature rupture of membranes, multiple pregnancy, breech presentation, excessive amniotic fluid, abnormal length of the umbilical cord and premature delivery.Some of the symptoms of umbilical cord prolapse include visible or palpable cord after water breaks, fetal heart rate abnormalities and maternal feeling of something coming out of the vagina.Umbilical cord prolapse can be diagnosed by physical examination, ultrasound or fetal heart rate monitoring.