Cord prolapse and the neonatal outcome

Abstract

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.

Keywords: Cord prolapse, Diagnosis to delivery interval, Obstetric practice, Neonatal outcome.