Which of the following patients is at highest risk for umbilical cord prolapse?

The correct answer is choice C. A client who has oligohydramnios.

Oligohydramnios is a condition where there is too little amniotic fluid around the fetus.This can cause the umbilical cord to slip down into the cervix or vagina before the baby, resulting in cord prolapse.

Cord prolapse can cut off the blood and oxygen supply to the baby and cause fetal distress or death.

Choice A is wrong because a client who is pregnant with twins is not at greater risk for cord prolapse unless there is also malpresentation of the fetuses, such as breech or transverse lie.

Choice B is wrong because a client who has gestational hypertension is not at greater risk for cord prolapse unless there is also polyhydramnios, which is excessive amniotic fluid around the fetus.

Choice D is wrong because a client who has placenta previa is not at greater risk for cord prolapse unless there is also artificial rupture of membranes by doctors.

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.