Cord prolapse and the neonatal outcome

Abstract

Aims and Objectives: The primary objective of this study was to determine the obstetric risk factors and the management protocol of cord prolapse in our unit through analysis of cases diagnosed over a period of 30 months. The secondary objective was to assess the neonatal outcomes that may be associated with cord prolapse.

Materials and Methods: A retrospective analysis for a period of 30 months was done during which there were 24 cases of cord prolapse (0.19% incidence) excluding cord presentations. The obstetric variables, parameters which determine the perinatal outcome were analysed. Statistical analyses were performed with the SPSS, Chi-Square test was used to test the statistical significance.

Results and Conclusion: The mean maternal age was 31.8±5.5 years. In 50% of the cases, labor was induced. The incidence of abnormal fetal presentation was 8%, and in two patients (8%) onset of labor was preterm. The mean diagnosis to delivery interval (DDI) was 15 minutes and 30 seconds; except for one vaginal delivery, all women underwent crash cesarean section delivery. There were no perinatal mortalities noted. It throws light onto whether DDI could be a critical determinant in deciding the neonatal outcome. Maneuvers to relieve pressure on the umbilical cord was followed but poorly documented (25%) as was the communication with the women and their partners. Various neonatal parameters such as the five-minute Apgar score, Cord pH, hypoxia ischemic encephalopathy (HIE), intubation during resuscitation and length of stay were assessed during the study which showed satisfactory neonatal outcomes.