If the umbilical cord is wrapped around the baby's neck, what is the recommended action?

• A. Pull the cord over the baby's head without clamping
• B. Clamp the cord in two spots and clip it in the middle
• C. Wait for spontaneous resolution without intervention
• D. Cut the cord immediately close to the baby

Answer: (B)

When a cord looped around the baby’s neck is present, the goal is to remove the loop without creating traction on the cord that could compromise blood flow. If you can slip the cord over the baby’s head quickly and safely, that is preferred. If that isn’t feasible, the safest approach is to clamp the cord in two spots on either side of the loop and cut between the clamps. This releases the loop from the neck without pulling on the cord, reducing the risk of vessel compression or tearing, while allowing delivery to proceed. Cutting the cord right at the baby or simply waiting for spontaneous resolution can leave the loop in place or introduce delays and potential oxygenation concerns. After the loop is freed, continue with standard newborn care and assess for any distress.