Answer
1. assess fetal viability
- check for cord pulsations
- if fetus already dead/too immature to survive/lethal anomaly, intervention for fetal reasons are inappropriate (allow vag deliv or c/s if transverse lie)
2. relieve cord compression
- if cord outside introitus, gently replace in vagina
- with hand in vagina, cradle cord in palm & use tips of fingers to elevate presenting part off of cord
- adjust maternal position to trendelenberg (head lower than pelvis) or knee-chest
3. method of delivery
- if cervix fully dilated & present part low, do assisted vag deliv
- if cervix not fully dilated/vag deliv dangerous, do immediate CS