Risk factors, maternal and neonatal outcome in umbilical cord prolapse in south Indian population

Abstract

Objective: To assess associated risk factors, maternal and neonatal outcome of pregnancies complicated by umbilical cord prolapse in South Indian population. Study design: It was a descriptive study. Risk factors, maternal and neonatal outcome were noted down retrospectively from case records of mothers affected by umbilical cord prolapse from April 2014 to March 2016. Results: There were 39 cases of umbilical cord prolapse in 2 years. The incidence of umbilical cord prolapse in our hospital was 0.1%. Most of the women were ≤ 25 years of age (72%). Primis were 56%. Most common presentation in umbilical cord prolapse was cephalic presentation (64%). Among the affected individuals, 82% had term gestation, 79% had higher presenting part, and 87% had spontaneous rupture of membranes. Babies were delivered by lower segment cesarean section (LSCS) in 95% and birth weight was ≥2.5 kg in 67% of cases with umbilical cord prolapse. Decision to delivery interval (DDI) was ≤30 minutes in 84% of cases. APGAR score was ≥7 at 1 minute in 65% and ≥7 at 5 minutes in 83% of cases. There were 15 neonatal intensive care unit (NICU) admissions and 2 stillbirths. Most common gender was male (75%). Conclusion: In our study, maternal risk factors were different from traditional risk factors in relation to age, parity, period of gestation, presentation, and birth weight. But, station of presenting part, early dilatation of cervix at diagnosis, and male gender predominance were similar to traditional risk factors. Neonatal outcome was good in our study with no birth injuries. All cases should be monitored properly to reduce the occurrence of umbilical cord prolapse even in low-risk population. Early detection and intervention is required for good neonatal outcome. Umbilical cord prolapse should be managed by an expert obstetrician.