• Palpate the prolapsed cord for pulsations

Pulsations present:

  • Place the patient in knee-chest position (“a la vache”)
  • Push the presenting part proximally with a hand in the vagina
  • Prepare for urgent C/S

Pulsations not present:

  • Proceed with vaginal delivery

Doubtful whether pulsations are present or not:

  • Check if fetal heart beats are present
  • Preferable with Doppler or ultrasound
  • Proceed accordingly