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Does cord presentation on ultrasound predict cord prolapse?
Yossef Ezra1, Suzanne R Strasberg, Dan Farine
1Maternal-Fetal Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Gynecologic and Obstetric Investigation
|July 18, 2003
Summary
Umbilical cord presentation on antenatal ultrasound is not synonymous with cord prolapse. Repeat scans and intrapartum assessment are crucial for determining delivery mode when cord presentation is identified.
Area of Science:
- Obstetrics and Gynecology
- Fetal Imaging
- Maternal-Fetal Medicine
Background:
- Umbilical cord prolapse is a rare but serious obstetric emergency.
- Antenatal detection of umbilical cord presentation may aid in predicting risk.
Purpose of the Study:
- To investigate the association between antenatal ultrasound-diagnosed umbilical cord presentation and the incidence of intrapartum cord prolapse.
- To evaluate the obstetric outcomes for pregnancies with identified cord presentation.
Main Methods:
- Retrospective review of antenatal records and sonograms from a 5-year period.
- Study A: Sonograms of patients with proven cord prolapse were reviewed for cord presentation.
- Study B: Obstetric outcomes of pregnancies with third-trimester sonographic cord presentation were analyzed.
Main Results:
- Only 12.5% of cord prolapse cases showed antenatal cord presentation on ultrasound.
- Cord presentation was identified in 0.16% of third-trimester sonograms.
- Of those with cord presentation, 23% required cesarean delivery, while 31% resolved spontaneously before delivery.
Conclusions:
- Antenatal umbilical cord presentation does not always lead to cord prolapse.
- Third-trimester cord presentation warrants serial scans and intrapartum ultrasound for delivery planning.