Consider the following statements:
Assertion (A): Breech presentation can cause cord prolapse.
Reason (R): The buttocks do not fully cover the internal OS, allowing the cord to descend.
Which of the following is correct?

1. A

   A is correct, but R is incorrect.

2. B

   A is incorrect, but R is correct.

3. C

   Both A and R are correct, but R does not explain the correct definition of A.

4. D

   Both A and R are correct, and R explains the correct definition of A.

Appeared in: NORCERT 8 Mains-2025

Explanation

Listen in Hindi

• The assertion that breech presentation can cause cord prolapse is a correct and clinically significant statement in obstetrics.
• The reason provided, that the buttocks do not fully cover the internal os, is the accurate anatomical and mechanical explanation for this increased risk.
• In a normal cephalic presentation, the fetal head acts as a natural plug, preventing the cord from descending.
• In a breech presentation, the irregular and softer presenting part (buttocks/feet) fails to create this seal, leaving gaps for the cord to prolapse, especially upon rupture of membranes.
• Therefore, the reason correctly and directly explains the assertion.

Why Other Options Were Wrong

• Option A: This option is incorrect because the Reason (R) is a factually correct statement. The poor fit of the breech presenting part is the established mechanism for increased cord prolapse risk.
• Option B: This option is incorrect because the Assertion (A) is a factually correct statement. Breech presentation is a major risk factor for cord prolapse.
• Option C: This option is incorrect because the Reason (R) is the direct and most accurate explanation for the Assertion (A). The anatomical mismatch described in R is precisely why the event in A occurs.

Related Visual

• Visual 1: Diagram - A comparative illustration showing a cephalic presentation with the head occluding the cervix versus a breech presentation with visible gaps around the presenting part, highlighting the potential pathway for cord prolapse.
• Visual 2: Flowchart - A simple flowchart showing: Breech Presentation → Irregular presenting part → Incomplete seal of internal os → Space for cord descent → Increased risk of Cord Prolapse.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of umbilical cord prolapse in breech presentation as background academic context rather than a clinical decision trigger.
• Umbilical cord prolapse is an obstetric emergency that can lead to fetal hypoxia, brain damage, or death due to compression of the cord between the presenting part and the pelvis.
• Nurses must be vigilant for cord prolapse in patients with known risk factors like breech presentation, especially during and after the rupture of membranes.
• Immediate nursing intervention for a diagnosed cord prolapse includes manually elevating the presenting part off the cord and placing the mother in a knee-chest or steep Trendelenburg position to use gravity to relieve pressure, while preparing for an emergency cesarean section.

How to Approach the Question

• First, evaluate the Assertion (A) independently. Determine if the statement 'Breech presentation can cause cord prolapse' is factually correct based on your nursing knowledge.
• Next, evaluate the Reason (R) independently. Determine if the statement 'The buttocks do not fully cover the internal OS, allowing the cord to descend' is a factually correct anatomical/physiological statement.
• If both statements are correct, proceed to the final step. If either is incorrect, you can quickly identify the right answer from the first two options.
• Finally, assess the relationship between the two statements. Ask yourself: 'Does Reason (R) provide the correct and direct explanation for why Assertion (A) is true?'
• Based on this three-step analysis (Is A true? Is R true? Does R explain A?), select the option that best describes the relationship.

Concept Tested & Keywords

• Concept Tested: Pathophysiology of umbilical cord prolapse in breech presentation
• Stem keywords: Breech presentation, cord prolapse, internal OS, Assertion, Reason
• Lead-in keywords: Which of the following is correct

Question ID

QZUPylJjTcFp3XEJQVX7zJ

Copy ID