Risk Factors And Perinatal Outcome In Umbilical Cord Prolapse

Abstract

The umbilical cord prolapse complicates 0.11 to 0.18% of live births. The overall incidence of umbilical cord prolapse is reported to be 0.1%–0.6% with higher incidences in non-cephalic presentations, multiple gestations, and earlier gestational ages. Preterm labour, multiparity, malpresentations, polyhydramnios, multiple gestations particularly in the second twin, preterm labor, and preterm premature rupture of membranes (PPROM),all have been associated with cord prolapse. The outcome of any fetus affected by cord prolapse depends on a number of factors which include, the gestational age, duration of cord  compression before interventional measure is instituted (diagnosis–delivery interval), the efficiency of the intrauterine resuscitation, and the definitive management adopted as well as the standard of the available neonatal care. Background: Umbilical cord prolapse is an obstetric emergency in which the umbilical cord comes through the cervical os in advance of or at the same time as the fetal presenting part leading to fatal complications. Methods: was a prospective observational study conducted in LD hospital an associated hospital of government medical college Srinagar for duration of 18 months. All pregnancies with cord prolapse were included in the study where as pregnancies with major fetal anomalies and Gestational age  < 28 weeks were excluded. Results: The incidence of cord prolapse during the course of study was found to be 0.0012% and the  maternal risk factors that were found to be associated with cord prolapse were multi gravida, twin pregnancy, malpresentations, pre-term premature rupture of membranes, amniotomy. Conclusion: Early detection and intervention is required for good perinatal outcome and umbilical cord prolapse should be managed as an obstetric emergency.

KEYWORDS: Diagnosis–Delivery Interval, Cord Prolapse, Multigravida, Malpresentations