In the management of a nuchal cord, what is the recommended initial action?

• A. Cut the cord immediately.
• B. Deliver by cesarean section.
• C. Slip a finger under the cord and gently attempt to slip it over the shoulder and head.
• D. Apply a tourniquet to the cord.

Answer: (C)

Relieve the neck constriction first. The best initial action is to slip a finger under the umbilical cord loop and gently guide it over the baby’s shoulder and head to free the neck. This relieves cord compression and helps prevent hypoxia during delivery without cutting the cord or resorting to cesarean. Cutting the cord immediately or applying a tourniquet isn’t the appropriate first step, and cesarean is not required unless other indications exist. The key is to manually loosen the cord rather than pulling on it.