Perinatal death associated with umbilical cord prolapse

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Neonatal Outcomes

Background:

• Umbilical cord prolapse is a rare but critical obstetric emergency.
• It can lead to severe fetal compromise and adverse perinatal outcomes.
• Understanding incidence and associated mortality is crucial for clinical management.

Purpose of the Study:

• To determine the incidence of umbilical cord prolapse.
• To assess the rates and characteristics of perinatal death and neonatal encephalopathy in association with cord prolapse.
• To analyze maternal and intrapartum factors influencing outcomes.

Main Methods:

• Retrospective cohort study design.
• Inclusion of all identified cases of umbilical cord prolapse over a 20-year period.
• Examination of perinatal death rates, neonatal encephalopathy, and maternal/intrapartum characteristics.

Main Results:

• The incidence of umbilical cord prolapse was 1.9 per 1000 deliveries, showing a decreasing trend over the study period.
• The perinatal death rate associated with cord prolapse was 6.8%, with higher rates observed in nulliparous women.
• Neonatal encephalopathy occurred in only 0.32% of cases; many perinatal deaths were diagnosed upon hospital presentation.

Conclusions:

• Umbilical cord prolapse presents a significant risk of perinatal mortality, estimated at approximately 7%.
• The incidence of neonatal encephalopathy related to cord prolapse is low.
• A substantial proportion of perinatal deaths were diagnosed on arrival, suggesting limited preventability through immediate hospital intervention.