For a nuchal cord, if there is more than one loop present, what is the initial action?

• A. Clamp and cut the cord immediately
• B. Wait for spontaneous resolution
• C. Gently slip a finger under the loop and pull it over the newborn’s head
• D. Apply traction to the cord

Answer: (C)

Relieving neck constriction is the priority when a nuchal cord is present. If there is more than one loop around the neck, the safest initial maneuver is to gently slip a finger under the loop and ease it up and over the newborn’s head. This relieves the compression and helps maintain blood flow while the delivery progresses. Clamping and cutting immediately, waiting for spontaneous resolution, or pulling on the cord would not relieve the constriction and could cause injury or distress. Once the head is delivered and the loop has been freed, continue with normal cord management.