Perinatal death associated with umbilical cord prolapse

Hehir, Mark P.; Hartigan, Lucia; Mahony, Rhona

doi:10.1515/jpm-2016-0223

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…3 The perinatal mortality rate was estimated at 6.8% and was likely to occur in nulliparous women. 20 Premature infants and those of low birth weight have less favorable outcomes and have twice the risk of perinatal mortality compared to those without UCP. 4 …”

Section: Perinatal Outcomementioning

confidence: 99%

“… 5 However, a recent study estimated a neonatal encephalopathy incidence of only 0.32%. 20 Neonatal encephalopathy was defined as either neonatal seizures or two of the following lasting longer than 24 h: abnormal consciousness, difficulty maintaining respiration or feeding (both of central origin), or abnormal tone/reflexes. 20 An increased incidence of placental abruption and meconium-stained amniotic fluid has been reported which can result in increased neonatal morbidity.…”

Section: Perinatal Outcomementioning

confidence: 99%

“…UCP has been shown to have an all-or-nothing effect on the neonatal outcome and the evidence for long term disability remains inconclusive. There is a very low incidence of neonatal encephalopathy; 20 however, long-term sequelae in the surviving infants in the form of cerebral palsy of the spastic quadriplegic and dyskinetic types have been reported in both preterm and term infants. 26 …”

Section: Perinatal Outcomementioning

confidence: 99%

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Optimal management of umbilical cord prolapse

Ali¹,

Hamdy²

2018

IJWH

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Umbilical cord prolapse (UCP) is an uncommon obstetric emergency that can have significant neonatal morbidity and/or mortality. It is diagnosed by seeing/palpating the prolapsed cord outside or within the vagina in addition to abnormal fetal heart rate patterns. Women at higher risk of UCP include multiparas with malpresentation. Other risk factors include polyhydramnios and multiple pregnancies. Iatrogenic UCP (up to 50% of cases) can occur in procedures such as amniotomy, fetal blood sampling, and insertion of a cervical ripening balloon. The perinatal outcome largely depends on the location where the prolapse occurred and the gestational age/birthweight of the fetus. When UCP is diagnosed, delivery should be expedited. Usually, cesarean section is the delivery mode of choice, but vaginal/instrumental delivery could be tried if deemed quicker, particularly in the second stage of labor. Diagnosis-to-delivery interval should ideally be less than 30 minutes; however, if it is expected to be lengthy, measures to relieve cord compression should be attempted. Manual elevation of the presenting part and Vago’s method (bladder filling) are the most commonly used maneuvers. Care should be given not to cause cord spasm with excessive manipulation. Simulation training has been shown to improve/maintain all aspects of management and documentation. Prompt diagnosis and interventions and the positive impact of neonatal management have significantly improved the neonatal outcome.

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Section: Perinatal Outcomementioning

confidence: 99%

Section: Perinatal Outcomementioning

confidence: 99%

Section: Perinatal Outcomementioning

confidence: 99%

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Optimal management of umbilical cord prolapse

Ali¹,

Hamdy²

2018

IJWH

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“…Se define como asfixia perinatal a la interrupción del flujo sanguíneo e intercambio de oxígeno hacia el feto asociado a un evento perinatal que produce hipoxemia e hipercapnia con acidosis metabólica significativa, la consecuencia directa es la EHI, la cual afecta al 1% de los recién nacidos a término o casi término y se estima que la incidencia actual asociada a prolapso de cordón umbilical es del 0.32% 5 . Dexter et al mencionan en una revisión sistemática que la incidencia global de prolapso del cordón calculada a partir de 21 estudios con un total de 11,057,165 embarazos fue del 0.17% y que existe una relación entre prolapso de cordón y una calificación de apgar menor a 7, en nuestro caso siendo de 5/6 6 .…”

Section: Discussionunclassified

Encefalopatía hipóxico-isquémica secundaria a prolapso de cordón umbilical

Tietzsch-Escalante,

Ramírez-Nova,

Duck-Hernández

et al. 2023

AMH

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El prolapso de cordón umbilical es una emergencia obstétrica que puede llevar a daño cerebral y muerte perinatal. La asfixia perinatal es una interrupción del flujo sanguíneo e intercambio de gas hacia el feto asociado a un evento perinatal como puede ser el prolapso de cordón umbilical. La consecuencia directa es la encefalopatía hipóxico-isquémica. Presentación del caso: Se trata de un recién nacido de término, a quien durante el trabajo de parto se hace el diagnóstico de prolapso de cordón umbilical, presentando al nacer ausencia de tono muscular y esfuerzo respiratorio, por lo que se dan maniobras avanzadas de reanimación, presenta actividad epileptiforme; tratado con anticonvulsivos y manejo oportuno con enfriamiento terapéutico, así como medidas de neuroprotección, resultado en una evolución tórpida. El diagnóstico oportuno y el tratamiento multisistémico en los pacientes con encefalopatía hipóxico-isquémica son el objetivo principal para mejorar el pronóstico de sobrevida de los recién nacidos en estadio moderado a severo.

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“…In Spain, perinatal deaths have decreased from 20 deaths per 1000 births in 1975 to 4.37 deaths per 1000 births in 2019 [ 4 ]. PD can occur as a result of maternal conditions [ 5 ] such as high blood pressure [ 6 ], anemia [ 7 ], diabetes, bacterial infections; fetal conditions such as congenital anomalies, intrauterine growth retardation, or multiple pregnancy; placental conditions such as premature detachment of the placenta or bleeding; uterine conditions such as uterine malformation; delivery conditions such as asphyxia during delivery hypoxia [ 8 ], umbilical cord prolapse [ 9 ], or complications of caesarean section [ 10 ] and other unclassifiable or unclear conditions [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review

Fernández‐Férez

Ventura-Miranda

Camacho-Ávila

et al. 2021

IJERPH

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Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses can develop interventions to improve the perinatal grief process. The aim of this review was to determine the efficacy of nursing interventions to facilitate the process of grief as a result of perinatal death. A systematic review of the literature was carried out. Studies that met the selection criteria underwent a quality assessment using the Joanna Briggs Institute critical appraisal tool. Four articles were selected out of the 640 found. Two are quasi-experimental studies, and two are randomized controlled clinical studies. The interventions that were analyzed positively improve psychological self-concept and role functions, as well as mutual commitment, depression, post-traumatic stress and symptoms of grief. These interventions are effective if they are carried out both before perinatal loss and after it has occurred. The support of health professionals for affected parents, their participation in the loss, expressing feelings and emotions, using distraction methods, group sessions, social support, physical activity, and family education are some of the effective interventions.

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Perinatal death associated with umbilical cord prolapse

Abstract: Cord prolapse carries a significant risk of perinatal death, approximately 7%. The corresponding rate of encephalopathy is low. A significant number of deaths were diagnosed on presentation to hospital and were not deemed preventable.

Cited by 8 publications

References 21 publications

Optimal management of umbilical cord prolapse

Optimal management of umbilical cord prolapse

Encefalopatía hipóxico-isquémica secundaria a prolapso de cordón umbilical

Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review

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