To determine the incidence, risk factors, obstetric management, maternal and neonatal outcome of umbilical cord prolapse (UCP) in order to improve the obstetric services
Methodology This is retrospective audit of all the cases of Umbilical cord prolapsed at Corniche Hospital during January 2009 and December 2010.
Results Twenty three cases diagnosed as umblical cord prolapse. The hospital based incidence of cord prolapse was 1:760. The mean Dignoses-Delivery Interval (DDI) was 18.5 Minutes. Eleven mothers (47.8%) delivered within this period of time. Eighty two percent women were multiparous. 86.9%were singleton pregnancies while 13.1% were (three sets) of twin gestations. Fifteen pregnancies (65.2%) were of more than 37 weeks of gestations. In 26.15% (n = 6)cases, fetuses were presented as breech. In majority of the case (n = 17) general anaesthesia was given (74%) for emrgency caesarean section (LSCS) and in 4 cases (17%) spinal anaesthesia was chosen for caesarean delivery. Tewnty two (95.65%) women were delivered by LSCS and one women had successful vaginal delivery after UCP.
Twenty three babies (80.7%) had apgar score at 5 minutes >7. Umblical cord PH was done in 65.2% (n = 15) of the cases. Arterial cord PH was recorded as less than 7.2 in 53.3% (n = 8) of the neonates. Sixteen babies required admission to NICU. We had 5 early neonatal deaths (19.2%) in our case series.However, there was no case of stillbirth or HIE directly related to cord prolapse.
Conclusion Cord prolapse is a rare but true obstetric emergency associated with high perinatal morbidity and mortality but with quick diagnosis and prompt multidisciplinary team management the outcome can be improved.
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