If the umbilical cord is wrapped too tightly around the infant's neck or around the neck more than once, preventing delivery, what is the immediate action?

• A. Clamp the umbilical cord with two clamps and cut the cord between them.
• B. Gently slip the cord over the baby's head and continue delivery.
• C. Loosen the cord from the neck by pulling on it.
• D. Ignore the cord and proceed with delivery.

Answer: (A)

When a nuchal cord is wrapped tightly around the neck and prevents delivery, the immediate action is to relieve the constriction quickly. Clamping the umbilical cord in two places and cutting the cord between them directly frees the baby from the cord while you continue delivery. This approach minimizes ongoing compression and allows the newborn to proceed with birth safely. If the cord can be slipped over the head, that is attempted first, but if it cannot be loosened, cutting between two clamps is the fastest, safest option. Pulling on the cord to loosen it is unsafe because it can injure the cord and harm the baby, and ignoring the cord is not an option.