FISDAP Obstetrics and Pediatrics Practice Test 2025 - Free Practice Questions and Study Guide

In a situation where a patient is experiencing an at-home birth with the fetus in a breech position (buttocks presenting) and has prolonged labor, assessing for a prolapsed cord is a critical first step. A prolapsed umbilical cord can occur when the presenting part of the fetus does not adequately fill the birth canal, leading to the cord slipping ahead of the fetus. This can compromise blood flow and oxygen delivery to the fetus, posing a significant risk of fetal distress or death.

Identifying a prolapsed cord allows for immediate intervention, such as relieving pressure on the cord if it is found to be prolapsed, or preparing for rapid transport to a facility equipped to handle complications associated with breech delivery. Prolonged labor in a breech presentation raises the risk of complications, making the assessment for a prolapsed cord crucial to ensure the safety of both the mother and the fetus.

While preparing for immediate transport, monitoring fetal heart tones, and requesting additional assistance from the midwife are also important actions in the overall management of this situation, they are secondary to the immediate need to check for a prolapsed cord, which affects the urgency and the execution of further interventions.