During assessment, you see the umbilical cord just outside the vagina of a woman in active labor. What is the appropriate response?

The situation described indicates a prolapsed umbilical cord, which is a medical emergency. When the umbilical cord is outside the vagina, there is a risk of cord compression, which can compromise fetal oxygenation and lead to significant fetal distress.

Positioning the mother in a knee-chest position is the most appropriate response because this position helps alleviate pressure on the umbilical cord. By having the mother assume this position, gravity assists in reducing pressure on the cord, which can help restore blood flow to the fetus and improve fetal heart rate. Additionally, this position may help the obstetrician or advanced care provider manage the situation more effectively once they arrive.

The other responses, while they may be components of an overall management plan, do not specifically address the immediate need to relieve pressure on the cord. Immediate transport may not give the necessary time to address the critical issue at hand. Administering oxygen can support the mother but does not address the underlying problem of cord compression. Requesting advanced care is essential, but without stabilizing the situation right away, the risk to the fetus remains high. Thus, the knee-chest position is pivotal in managing a cord prolapse effectively and improving outcomes for both the mother and the baby.