Umbilical cord prolapse during delivery - risk factors and pregnancy outcome: a single center experience

J Matern Fetal Neonatal Med. 2014 Jan;27(1):14-7. doi: 10.3109/14767058.2013.799651. Epub 2013 May 30.

Abstract

Objective: To determine the incidence and risk factors for umbilical cord prolapse and to evaluate whether obstetrical interventions increase this risk.

Methods: A retrospective, cohort study of all intended vaginal deliveries in a single tertiary university affiliated medical center (33 519 deliveries). Obstetrical and labor characteristics, including labor interventions [as artificial rupture of membranes (ARM) and intrauterine catheter insertion] and short-term pregnancy outcome were obtained. Primary outcome measure was defined as abnormal umbilical cord pH <7.2 and/or 5-min Apgar score <7.

Results: The rate of umbilical cord prolapse was 37/33 519 (0.11%); of them, 23 (62%) were diagnosed after ARM, three cases (8%) were related to external cephalic version and three cases (8%) were related to intrauterine catheter insertion. The rate of umbilical cord pH <7.2 and 5-min Apgar score <7 was higher in the ARM group in comparison to women with spontaneous rupture of membranes (30% versus 21%, p = 0.8). There was no significant difference in mean pH according to mode of delivery. All neonates were discharged within 8 d of delivery with good neonatal outcome and the rate of maternal complications was low.

Conclusion: Prompt delivery in cases of umbilical cord prolapse is associated with favorable pregnancy outcome.

MeSH terms

  • Apgar Score
  • Bradycardia / diagnosis
  • Catheters / statistics & numerical data
  • Cohort Studies
  • Delivery, Obstetric / statistics & numerical data
  • Extraembryonic Membranes
  • Female
  • Fetal Diseases / diagnosis*
  • Hospitals, University
  • Humans
  • Hydrogen-Ion Concentration
  • Infant, Newborn
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Labor, Induced / adverse effects
  • Pregnancy
  • Prolapse
  • Retrospective Studies
  • Risk Factors
  • Umbilical Cord* / chemistry
  • Version, Fetal / statistics & numerical data