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

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 (33519 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 37/33519 (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 8d 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.