MANAGEMENT OF CHILDBIRTH CARE FOR MRS. E, 31 YEARS OLD, G4P3A0, WITH UMBILICAL CORD PROLAPSE AT NIAR PRIMARY CLINIC IN 2026

Novitaria Zega; Klara Devega; Anita Perawati Beru Singarimbun; Retno Wahyuni; Juniarsih

Authors

Novitaria Zega Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Klara Devega Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Anita Perawati Beru Singarimbun Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Retno Wahyuni Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Juniarsih Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan

Keywords:

Nuchal Cord, Labor, Midwifery Care, Helen Varney, Fetal Distress

Abstract

Background: Nuchal cord is a common complication during pregnancy and labor that occurs when the umbilical cord wraps around the fetal neck. This condition may impair placental-fetal blood circulation, increasing the risk of fetal hypoxia, fetal distress, and neonatal asphyxia. Early detection and appropriate management are essential to prevent adverse maternal and neonatal outcomes. Inadequate antenatal care (ANC) may contribute to delayed identification of such complications. Objective: To analyze the implementation of midwifery care management in a case of nuchal cord using Helen Varney’sret Seven-Step Midwifery Management Approach. Methods: This descriptive case study was conducted at Niar Primary Clinic in 2026. The subject was Mrs. E, a 31-year-old G4P3A0 woman at 39 weeks of gestation who experienced a nuchal cord during labor. Data were collected through interviews, observation, physical examination, medical record review, and documentation. Midwifery care was implemented and evaluated based on Helen Varney’s seven-step management process. Results: The assessment showed that the mother attended only two ANC visits during pregnancy. During labor, the fetal heart rate decreased from 120 to 100 beats per minute and became irregular, indicating possible fetal distress. After delivery of the fetal head, a double nuchal cord was identified around the infant’s neck. Immediate management included releasing the cord loops and closely monitoring maternal and fetal conditions. The infant was delivered safely and required initial assessment and immediate stimulation. Conclusion: Helen Varney’s Seven-Step Midwifery Management Approach enabled early identification of complications, appropriate clinical decision-making, and timely intervention. Its application contributed to the successful management of the nuchal cord case and minimized the risk of complications for both mother and newborn.

References

Dias, Z. And Kore, S. (2021) “Perinatal Outcome In Pregnancies With Nuchal Cord : Prospective Cross-Sectional Study At Tertiary Care Institute,” 10(6), Pp. 2368–2373.

Febriana Sari, F. Et Al. (No Date) “Childbirth Due To Uterine Antonia In Primary Health Care.”

Handajani, D.O., Mulyani, E. And Rachmawati, A. (2021) “Factors Related To The Provision Of Complementary Foods For Breastfeeding, Indonesian Journal Of Public Health, 16(3), P. 195. Available At: Https://Doi.Org/10.26714/Jkmi.16.3.2021.195-202.

Hasmiati, T. (2025) “Literature Study: The Use Of Colostrum As An Innovation In Umbilical Cord Care For Newborn Babies,” Nursing Journal, 17, Pp. 733–748.

Ikterik, B. Et Al. (2025) “Case Report Of Comprehensive Midwifery Care On Ms. Y, 29 Years Old, With Chronic Energy Deficiency, Umbilical Cord Cord Wrap And,” 16(01), Pp. 1–13.

Journal, M.H., Haryanti, D. And Inayah, W. (2022) “The Relationship Between Twin Pregnancy And Polyhydramnios With The Occurrence Of Umbilical Cord Wraps At H. Abdul Manap Regional Hospital,” Midwifery Health Journal, 7(2).

Kumar, P. Et Al. (2024) “Abnormal Umbilical Cord Coiling And Association With Pregnancy Factors,” 0, Pp. 44–52. Available At: Https://Doi.Org/10.4274/Jtgga.Galenos.2023.2023-3-3.

Laiya, M.N., Kurnaesih, E. And Azrida, M. (2021) “Intranatal Midwifery Care Management For Mrs. N With Umbilical Cord Around The Neck Address: Phone: Article History:,” 02(01), Pp. 12–22.

Miska, T., Yuswita And Nuraina (2024) “Midwifery Care During Childbirth With Umbilical Cord Circulation, Journal Of Maternal And Child Health Science, 4(1), Pp. 38–44.

Munadhoroh (2026) “The Relationship Between Topical Breastfeeding On The Umbilical Cord And The Duration Of Umbilical Cord Separation In Megonten Village, Kebon Agung, Demak District,” Journal Medicare, 5, Pp. 991–997.

Pengetahuan, G. Et Al. (2024) “Indonesian Health Scientific Journal (Jurnal Kesehatan Ilmiah Indonesia) Indonesian Health Scientific Journal ( Indonesian Health Scientific Journal ),” 9(2).

Sinaga, R. (2024) “Midwifery Care Management For Postpartum Mother Mrs. N Pratama Nirmala In Mendan Perjuangan Sub-District, North Sumatera Province, Year 2024.

Siti Nurmawan Et Al. (2024) “The Relationship Between Mothers' Level Of Knowledge And Umbilical Cord Care At Pmb Nurlina Sikumbang, Sampali Village, Deli Serdang Regency, North Sumatra Province In 2024.”

Surbakti, I.S. (2024) “Literature Review On The Relationship Between Premature Rupture Of Membranes And The Occurrence Of Asphyxia In Newborns.”

Varner, M., Poeltler, D. And Vaucher, Y. (2024) “Umbilical Cord Milking In Non-Vigorous Infants: A Cluster-Randomized Crossover Trial,” Hhs Pub Lic Access, 228(2), Pp. 1–23. Available At: Https://Doi.Org/10.1016/J.Ajog.2022.08.015.Umbilical.