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

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.