The correct answer is choice A, B and E. Umbilical cord prolapse is a complication that occurs when the umbilical cord descends through the cervix before or with the presenting part of the fetus.

This can cause fetal hypoxia due to occlusion or vasospasm of the cord.

The risk factors for cord prolapse include:

• Premature rupture of membranes (choice A): This can cause the cord to slip past the fetal head or limbs when the amniotic fluid gushes out.

• Breech presentation (choice B): This is when the fetus is positioned with its feet or buttocks first. In a footling breech, the cord can easily slip between and past the fetal feet and into the pelvis.

• Cephalopelvic disproportion (choice C): This is when the fetal head is too large to fit through the maternal pelvis. This is not a risk factor for cord prolapse, as the fetal head usually prevents the cord from descending.

• Gestational diabetes (choice D): This is a condition where the mother has high blood sugar levels during pregnancy. This can cause macrosomia (large baby), but this is not a direct risk factor for cord prolapse.

• Hydramnios (choice E): This is a condition where there is excessive amniotic fluid around the fetus. This can create more space for the cord to move and prolapse, especially if there is a sudden loss of fluid.

Normal ranges for amniotic fluid index