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Umbilical cord prolapse. A contemporary look.
P P Koonings1, R H Paul, K Campbell
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine and Women's Hospital, Los Angeles.
The Journal of Reproductive Medicine
|July 1, 1990
Summary
Medical intervention for umbilical cord prolapse significantly reduces perinatal mortality. This study found that less intervention correlated with higher fetal death rates, with no deaths occurring in the hospital.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Umbilical cord prolapse is a rare but serious obstetric emergency.
- The optimal management strategy for umbilical cord prolapse remains debated.
- Limited data exists on the impact of varying levels of medical intervention.
Purpose of the Study:
- To evaluate the association between the level of medical intervention and perinatal outcomes in cases of umbilical cord prolapse.
- To determine if increased medical intervention improves fetal survival rates.
Main Methods:
- Retrospective review of all umbilical cord prolapse cases over a nine-year period.
- Data collected from Women's Hospital, Los Angeles County-University of Southern California Medical Center.
- Analysis of perinatal mortality rates in relation to the degree of medical intervention.
Main Results:
- A significant inverse correlation was observed between the level of medical intervention and the perinatal mortality rate.
- Cases with decreased medical intervention showed a statistically significant increase in fetal mortality.
- No fetal deaths were recorded among infants managed within the hospital.
Conclusions:
- Active medical intervention in cases of umbilical cord prolapse is associated with improved perinatal survival.
- Minimizing intervention may lead to poorer outcomes for the fetus.
- Hospital-based management appears critical for preventing fetal demise in umbilical cord prolapse.