ABSTRACT
Immediate vaginal or speculum examination should be carried out following membrane rupture in the following pregnancy risk groups: cardiotocographic abnormality, unengaged presenting part, malpresentation, prematurity, multiple pregnancy and polyhydramnios. Immediate delivery of the baby is required in all cases of umbilical cord prolapse. The obstetric specialist registrar, an anaesthetist and paediatrician should all be summoned immediately, while positioning the woman in the knee-chest or exaggerated Sims position. Blood should be taken for urgent group and save serum or cross-matching if Caesarean section (CS) is to be performed. If the cervix is fully dilated and the head is low, ventouse or forceps delivery may be performed. If the cervix is not fully dilated, CS should be undertaken unless the fetus is dead or very premature, depending on circumstances.
