Prolapse of the Umbilical Cord

Bock, Johannes E.; Wiese, J

doi:10.3109/00016347209156863

Cited by 11 publications

(5 citation statements)

References 8 publications

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“…DDI less than 30 minutes is associated with lower mortality rates in infants >2,500 g 21 and higher Apgar scores. 6 , 22 However, hypoxemic encephalopathy had been reported with very short DDI (<15 minutes), which suggests that other factors may play part in the outcome.…”

Section: Perinatal Outcomementioning

confidence: 88%

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: 88%

Optimal management of umbilical cord prolapse

Ali¹,

Hamdy²

2018

IJWH

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“…The use of cesarean section in the case of extremely low gestational age is controversial (6) and some centres have a restrictive policy based on a gestational age limit for cesarean section. Similarly, the use of vigorous resuscitation or intensive care for a baby born more than 3 months before term must be assessed carefully (7).…”

Section: Discussionmentioning

confidence: 99%

Unexpected Survival After Conservative Management of Cord Prolapse in Two Very Preterm Babies

Jacobsen

Madsen

1990

Acta Obstet Gynecol Scand

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Two very preterm infants (24 and 25 weeks) were born vaginally in spite of prolapse of the umbilical cord. The prolapses lasted 45 min and 2 h, respectively, but though both babies were at first believed to be lost, they survived, only mild to moderate asphyxia, and both were discharged well. One of the babies later developed slight neurological sequelae. Even a very preterm baby has the possibility of surviving vaginal delivery complicated by cord prolapse.

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“…Abnormal fetal presentation, multiparity, multiple gestation, and prematurity-factors that lead to inadequate filling of the maternal pelvis with the fetal presenting part-were previously reported as risk factors for umbilical cord prolapse. [1][2][3][4][5][6][7] In our study, the presentation was noncephalic in 42% of the cases with an incidence of breech presentation 10 times greater than that of our general obstetrical population (34 vs. 3%) and of transverse lie 6 times that of our general population (6 vs. 1%). Fourteen percent of the cases occurred in twin gestation, an incidence of twins 14 times that of the general population (14 vs. 1%).…”

Section: Discussionmentioning

confidence: 78%

“…The incidence of cord prolapse in our study is 0.24%, which is similar to the 0.1-0.6% incidence reported in the literature. 3,4 However, our study has included infants that were previously considered nonviable. Abnormal fetal presentation, multiparity, multiple gestation, and prematurity-factors that lead to inadequate filling of the maternal pelvis with the fetal presenting part-were previously reported as risk factors for umbilical cord prolapse.…”

Section: Discussionmentioning

confidence: 99%