Prolapse of the umbilical cord, including a late follow-up of fetal survivors

Cushner, Irvin M.

doi:10.1016/s0002-9378(15)33513-4

Cited by 28 publications

(6 citation statements)

References 15 publications

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“…If it is performed before the head is engaged, the risk of prolapse is high (2,4,5). If it is performed before the head is engaged, the risk of prolapse is high (2,4,5).…”

mentioning

confidence: 99%

Prolapse and Presentation of the Umbilical Cord

Woo

Ngan

1983

Aust NZ J Obst Gynaeco

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The outcome of pregnancies with prolapse and presentation of the umbilical cord at Tsan Yuk Hospital, Hong Kong, 1976 to 1982, was reviewed. The incidence was 0.17%, 70 of 41,939 deliveries; 98% of cases were diagnosed in hospital. Breech presentation, low birth-weight and artificial rupture of membranes were found to be significant associations; 78% of cases were discovered by vaginal examination and the diagnosis-delivery interval was less than 30 minutes in 75%. There were 8 perinatal deaths and 3 of these occurred in babies whose birth-weights were less than 1,000 g; 2 stillbirths were associated with presentation of the cord. The corrected perinatal mortality was 8.6% with a corresponding Caesarean section rate of 73.3%. 80% of the babies born by Caesarean section had 5 minutes Apgar scores of 7 or more. It was concluded that early diagnosis of umbilical cord prolapse followed by prompt treatment are effective in reducing the perinatal mortality rate. Energetic intrapartum monitoring is also essential in order that patients with occult prolapse or presentation of the umbilical cord be diagnosed early and treated promptly.

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“…If it is performed before the head is engaged, the risk of prolapse is high (2,4,5). If it is performed before the head is engaged, the risk of prolapse is high (2,4,5).…”

mentioning

confidence: 99%

Prolapse and Presentation of the Umbilical Cord

Woo

Ngan

1983

Aust NZ J Obst Gynaeco

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“…It was concluded that cord complications played a major role in perinatal mortality and morbidity but the occurence of cord complications never exceeded 20 per cent of the total number of risk factors. Although the present material did not include prolapsed cords this Situation is only present in about 0.4% of all deliveries [4] compared to other cord complications being present in about 30% of all deliveries.…”

Section: Discussionmentioning

confidence: 92%

“…In one of these papers [2] no control group without cord complications was used; in the other paper only cases with innocuous cardiotocographic patterns (CTG) were included in the control group [12]. Although cord prolapse is a very dangerous Situation if delivery is not terminated at once [1], this Situation only occurs in 0.43 per cent of all deliveries [4] and the effect of all other types of cord complications per se still remains to be investigated. As 152 patients in our department were monitored with continuous scalp tissue pH (tpH) during labour followed by determination of the oxygenation and acid base state of both umbilical artery and vein, and äs the position of the umbilical cord was noted in 142 of these patients, we have had the opportunity of investigating the effect of cord complications per se on all the above mentioned values and on the APGAR score.…”

Section: T Webermentioning

confidence: 99%

The influence of cord complications on fetal pH, neonatal APGAR score, and the acid base state and oxygenation of the umbilical artery and vein

Weber¹

1981

Journal of Perinatal Medicine

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Continuous monitoring of fetal scalp tissue pH (tpH), acid base and oxygenation measurements of the blood of the umbilical artery and vein, and APGAR scoring was performed in 152 deliveries. The effect of cord complication on tpH (120, 90, 60, 30, 15, 10, 5, and 0 minutes before delivery), the status of the umbilical artery and vein (pH, pCO2, base excess, standard bicarbonate, pO2, and oxygen saturation), and the APGAR scores (one and five minutes after delivery) were investigated. Thirty-two per cent of the deliveries were associated with on or more cord complication(s). Cord complications in general did not influence the APGAR scores, the acid base state, or the oxygenation of the fetus and newborn. In the very few cases of tight cord complication(s) tpH showed a marked decrease during the last 30 minutes of labour, the umbilical blood was slightly acidotic, but the APGAR scores were normal (8-10 one and five minutes after delivery). No cases of prolapse of the cord were found. Cord complications are very common but in most cases completely harmless.

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“…Sie ziehen in Erwägung, dass eine vorangegangene Schädigung des Kindes die primäre Ursache für einen NSV sein könnte. Cushner [8], Uygur et al [35] sowie eigene Ergebnisse zeigen, dass die Nabelschnur auch vorfallen kann, wenn der vorangehende Kindesteil vorher einen Bezug zum Becken hatte. Auch kann sich ein bereits fixierter vorangehender Kindesteil wieder lockern ( [17], persönliche Mitteilung und eigene Erfahrung).…”

Section: Befragung Von öSterreichischen Fachleutenunclassified

Hinlegen und Liegendtransport nach Blasensprung

Oblasser¹

2007

Z Geburtshilfe Neonatol

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Ein Vorfall der Nabelschnur ist eine seltene aber ernste Komplikation nach dem Blasensprung. Um diesen zu vermeiden, empfehlen Hebammen und GeburtshelferInnen in Österreich Schwangeren häufig, sich nach dem Blasensprung zu Hause hinzulegen und liegen zu bleiben, bis eine Betreuungsperson bestätigt hat, daß der vorangehende Kindesteil im mütterlichen Becken fixiert ist. Diese Empfehlung hat Nachteile und der Glaube an ihre Wirksamkeit wird nicht durch wissenschaftliche Nachweise unterstützt. Die vorgestellte Studie zielte auf eine Informationssammlung über die Empfehlung, die als Basis dazu dienen kann, ihre Verwendung zur Diskussion zu stellen und Forschung über ihre Wirksamkeit durchzuführen. Sie wurde als deskriptive Erhebung in drei Teilen durchgeführt: " Eine internationale E-mail / postalische Fragebogen-Erhebung unter einer GelegenheitsStichprobe von nationalen Hebammenorganisationen bzw. Hebammen sollte herausfinden, ob diese Praxis auch in anderen Ländern üblich ist. " Ein österreichweiter postalischer FragebogenZensus unter allen 1636 Hebammen und eine E-mail Fragebogen-Erhebung unter etwa 600 GynäkologInnen sollte feststellen, wie verbreitet die Praxis ist und was Fachleute darüber denken. " Standardisierte Interviews mit einer Gelegenheits-Stichprobe von 25 Frauen nach der Geburt, die einen Blasensprung zu Hause erlebt hatten, sollten deren Erfahrungen mit der Empfehlung und ihre Compliance herausfinden. Die Daten wurden mittels deskriptiver Statistik und Inhaltsanalyse ausgewertet. Die Ergebnisse zeigen, dass die Empfehlung nicht in allen Län-dern bekannt ist. Wenn ja, wird sie meist weniger streng oder gar nicht angewandt. Fachleute in Österreich verwenden sie nicht einheitlich. Etwa die Hälfte von ihnen glaubt nicht an die Abstract !

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Prolapse of the umbilical cord, including a late follow-up of fetal survivors

Cited by 28 publications

References 15 publications

Prolapse and Presentation of the Umbilical Cord

Prolapse and Presentation of the Umbilical Cord

The influence of cord complications on fetal pH, neonatal APGAR score, and the acid base state and oxygenation of the umbilical artery and vein

Hinlegen und Liegendtransport nach Blasensprung

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