Your 22-year-old patient is in active labor. What is the appropriate management when the infant's leg is protruding from the vagina?

In a scenario where an infant's leg is protruding from the vagina, the appropriate management involves placing the mother supine with her head down and pelvis elevated. This positioning can help promote the safe delivery of the baby by using gravity to assist in the delivery process while also preventing any compression of the umbilical cord that may occur due to the positioning.

By elevating the pelvis, this method aligns the body in a way that can facilitate proper alignment for delivery, minimizing the risk of complications. It's important to maintain an open pathway for the baby and provide adequate support and positioning during an unexpected delivery.

The other options involve actions that could be either ineffective or pose a risk to both the mother and the baby. For instance, pulling on the infant's leg could cause harm or injury, while attempting to push the leg off the umbilical cord might lead to further complications, including cord entrapment or insufficient blood flow to the infant. Rapid transport without addressing the situation could also endanger both mother and baby, as proper management is crucial during an active labor scenario with a limb presentation.