Umbilical cord prolapse: Risk factors and perinatal outcomes

Objectives: To determine obstetric risk factors and perinatal outcomes of pregnancies complicated by umbilical cord prolapse. Material and Method: This was a retrospective study conducted at the Department of Maternal Fetal Medicine of the Bakirkoy Women and Children's Teaching Hospital between 2000 and 2007. Birth records of 110 cases with umbilical cord prolapse and 600 randomly selected controls were reviewed retrospectively. Results: Prolapse of the umbilical cord complicated 0.4% (ns456) of all deliveries included in the study. Multiparity wase more common in patients with umbilical cord prolapse (% 70-% 45.5 P< 0.001). Umbilical cord prolapse occurred in breech presentation in 17 cases (% 15.5) and in transverse presentation in five of the cases (% 4.5). The occurrence of breech presentation among the control cases was% 2 (P< 0.001). Elective amniotomy and polyhydramnios were risk factors for umbilical cord prolapse (P< 0.001). No statistically significant difference was noted in the multiple pregnancy between the groups (p= 0.86). Fetuses with umbilical cord prolapse had lower fetal weight [2500 gram <] (% 34.4-10.4, P< 0.001). The mean Apgar score of neonate at 5. Minutes after delivery was 8.45 +/-(SD) 1.13 and 8.97 +/- 0.8 in the prolapsed group and in the control group, respectively (p < 0.001). The Perinatal mortality rate was % 1.8. Conclusion: Abnormal fetal presentation, multiparity, low birth weight [2500 gram <] and polyhydramnios, are risk factors for umbilical cord prolapse. More closer follow- up must be done for the cases who caries risk factors. Emergent cesarean section must be performed for the patients who have diagnosed as umbilical cord prolapsus. So perinatal mortality rate should be reduced.