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Risk factors and Perinatal Outcome of Umbilical Cord Prolapse in Sagamu, Nigeria

M A Lamina, P O Adefuye, A F Akinsanya, O Odubena

Abstract


Background: Umbilical cord prolapse is an obstetric emergency that threatens the life and well-being of the fetus and also increases maternal morbidity. Fetal survival in umbilical cord prolapse can be enhanced by prevention where risk factors are identified and prompt diagnosis and decisive intervention.

 Objective: The aim of this study was to determine the incidence, identify the risk factors associated with umbilical cord prolapse and document the perinatal outcome of cases of cord prolapse.

Methods: This was a 13-year retrospective case-control study of cases of umbilical cord prolapse seen at the OOUTH, Sagamu, Southwestern Nigeria between January 1, 2000 and December 31, 2012.

Result: During the study period, the incidence of umbilical cord prolapse was 1 in 122 deliveries (0.82%). The umbilical cord prolapse occurred in association with breech presentation five times (33.3%) and transverse lie eleven times (18.5%). The occurrence of breech presentation among the control cases was 8.6% (p<0.001) and that of transverse lie was 1.9% (p<0.001). There were also significant statistical differences between the cases of cord prolapse and controls in terms of prematurity, low birth weight, unbooked status and multiparity.  The perinatal rate was 222/1000 (22.2%) compared to the perinatal mortality of 68/1000 (6.8%) for the control group.

Conclusion: It is suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care as this will enhance early identification of the risk factors and appropriate management instituted to reduce perinatal mortality.


Keywords


cord prolapse; emergency care; Nigeria; perinatal outcome; risk factors.

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References


Dilbaz B, Ozturkoglu E, Dilbaz S, Sivaslioglu AA, Haberal A. Risk factors and perinatal outcomes associated with umbilical cord prolapse. Arch Gynaecol Obstet 2006;274: 104-7.

Critchlow CW, Lee TL, Benedetti TJ, Daling JR. Risk factors and infant outcomes associated with umbilical cord prolapse: population based case control study among births in Washington State. Am J Obstet Gynaecol 1994;170: 613-8.

Kwawukume EY. Cord prolapse. In: Kwawukume EY, Emuveyan EE, editors. Comprehensive obstetrics in the Tropics. Dansoman Asante and Hittscher Printing Press Ltd; 2002, p.208-10.

Kalu CA, Umeora OUJ. Risk factors and perinatal outcomes associated with umbilical cord prolapse in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. Niger J Clin Pract 2011;14:413-7.

Johanson R. Malposition, Malpresentation and Cephalopelvic disproportion. In: Edmonds DK, editor. Dewhurst’s Textbook of Obstetrics and Gynaecology for Postgraduates. 6th ed. Hoboken, New Jersey:Blackwell Science; 1999.p.277-90.

Enekpene CA, Omigbodun AO, Arowojolu AO. Perinatal mortality following umbilical cord prolapse. Int J Gynaecol Obstet 2006;95:44-5.

Uygur D, Kis S,Tuncer R, Ozcan FS, Erkaya S. Risk factors and infant outcomes associated with umbilical cord prolapse. Int J Gynaecol Obstet 2002;78:127-30.

Panter KR, Hannah ME. Umbilical cord prolapse. So far so good? Lancet 1996;347:74.

Koonings PP, Paul RH, Campbell K. Umbilical cord prolapse. A contemporary look. J Reprod Med 1990;35:690-2.

Roberts WE, Martin RW, Roach HH, Perry KG Jr, Martin JN Jr. Morrison JC. Are obstetric interventions such as cervical ripening, induction of labor, amnioinfusion, or amniotomy associated with umbilical cord prolapse? Am J Obstet Gynaecol 1997;176:1181-5.

Fenton AN, d’ Esopo A. Prolapse of the cord during labor. Am J Obstet Gynaecol 1951;62:52-64.

Melseh T, Sultan M, Sabagh T, Algwiser A. Umbilical cord prolapse. J Obstet Gynaecol 1999;13:24-8.

Murphy DJ, MacKenzie IZ. The mortality and morbidity associated with umbilical cord prolapse. Br J Obstet Gynaecol. 1995;102:826-30.

Collae JV. Malpresentation and cord prolapse. In: Decherney AH, Pernoll ML, editors. Current obstetric and gynaecological diagnosis and treatment. 8th ed. New York: Lange Medical Books; 1998.p.410-27.

Yla-Outinen A, Heinonen PK, Tuimala R. Predisposing and risk factors of umbilical cord prolapse. Acta Obstet Gynaecol Scand 1985;64:567-70.

Dare FO, Owolabi AT, Fasuba OB & Ezechi OC. Umbilical cord prolapse: A clinical study of 60 cases seen in Obafemi Awolowo University Teaching Hospital, Ile-Ife. East Afr Med J, 1998; 75(5):308-10.

Onwuhafua PI, Adesiyun G, Oguntayo A. Umbilical cord prolapse- A clinical study from Kaduna, Nigeria. Tropical Journal of Obstetrics and Gynaecology, 2002;19(2):24-26.

Beloqolovkin V, Bush M, Eddleman K. Umbilical cord prolapse. In: Up to Date version, 14,2,2006 on CD Rom.

Bako B, Chama C, Audu BM. Emergency obstetric care in a Nigerian Tertiary Hospital: A 20-year review of umbilical cord prolapse. Niger J Clin Pract 2009;12(3):232-36.

Woo JS, Ngan YS, Ma HK. Prolapse and presentation of the umbilical cord. Aust N Z J Obstet Gynaecol, 1983;23(3):142-5.

Kahana B, Sheiner E, Levy A, Layer S, Mayor M. Umbilical cord prolapse and perinatal outcomes. Int J Gynaecol Obstet 2004;84:127-32.

Sornes T, Bakke T. Uterine size, parity and umbilical cord length. Acta Obstet Gynecol Scand, 1989;68(5):439-41.

Dufour P, Vinatier D, Bennani S, Tordjeman N, Fondras C, Monnier JC, Codaccioni X, Leguien P, Puech F. Cord prolapse- A review of literature: A series of 50 cases. J Gynaecol Obstet Bio Reprod (Paris), 1996;25(8):841-5.

Faiz SA, Habib FA, Sporrong BG, Khalil NA. Results of delivery in umbilical cord prolapse. Saudi Med J 2003;24(7):754-7.

Yeap ML, Kwek K, Tee CS, Yeo GSH. Umbilical cord prolapse and emergency caesarean section- A review of 25 cases. The Internet Journal of Gynaecology and Obstetrics, 2001;1(1):157-61.

Tan WC, Tan LK, Tan HK, Tan AS. Audit of crash emergency caesarean sections due to cord prolapse in terms of response time and perinatal outcome. Ann Acad Med Singapore, 2003;32(5):638-41.

Prabulos AM, Philpson EH. Umbilical cord prolapse, is the time from diagnosis to delivery critical? J Reprod Med,1998;43(2):129-32.


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A publication of the Medical and Dental Consultants Association of Nigeria, Olabisi Onabanjo University Teaching Hospital, (OOUTH) Sagamu Branch, Nigeria