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Exaggerated Sims Position

    Indications
    • To relieve pressure on the umbilical cord in presence of prolapse (where the umbilical cord lies in front or beside presenting part and membranes are ruptured)
    Risk Factors for Umbilical Cord Prolapse
    • Abnormally long umbilical cord
    • Contracted pelvis/pelvic tumors
    • Low birth weight (<2,500 g)
    • Malpresentation/malposition
    • Multiple gestation
    • Multiparity
    • Polyhydramnios
    • Prematurity Spontaneous rupture of membranes
    Technique
    • Have the patient lie on their left side with chest flat on the bed in a semi-prone position
    • Right knee and thigh drawn in towards chest
    • Left arm lies along her back
    • Place a pillow/wedge under their left hip/buttocks
    • Can place the bed in trendelenberg (where the head of the head is slightly angled down and the feet are angle up) to increase effectiveness of position
    Editors & Reviewers

    Editor:

    • Anthony J. Busti, MD, PharmD, FNLA, FAHA

    Last Reviewed:  September 2016

    References
    1. Dilbaz B et al. Risk factors and perinatal outcomes associated with umbilical cord prolapse. Arch Gynecol Obstet. 2006;274(2):104-7.
    2. Lindsay P. Presentation and Prolapse of the Umbilical Cord. In: Henderson C, MacDonald S, editors. Mayes' Midwifery A textbook for Midwives. 13th ed. London: Bailiere Tindall; 2004. p. 954-59.