What is the recommended initial action if a nuchal cord is found around the neonate’s neck?

• A. Slip the cord over the infant’s shoulder with two fingers
• B. Cut the cord immediately
• C. Apply gentle traction to the cord
• D. Delay management until after birth

Answer: (A)

When a nuchal cord is present, the first step is to gently loosen it by sliding the cord over the baby’s head (or shoulder) using two fingers. This frees the neck without pulling on the cord, which could compress vessels or injure the newborn. Keeping the cord intact and avoiding traction helps maintain the baby’s oxygen supply during delivery. Cutting the cord immediately isn’t needed and can prematurely separate the baby from placental circulation, and pulling on the cord can cause injury. Delaying management isn’t appropriate because the cord constriction needs to be relieved promptly to reduce risk to the baby.