Exaggerated Sims Position
- 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)
- Abnormally long umbilical cord
- Contracted pelvis/pelvic tumors
- Low birth weight (<2,500 g)
- Multiple gestation
- Prematurity Spontaneous rupture of membranes
- 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
- Dilbaz B et al. Risk factors and perinatal outcomes associated with umbilical cord prolapse. Arch Gynecol Obstet. 2006;274(2):104-7.
- 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.
Risk Factors for Umbilical Cord Prolapse