Cord prolapse: is antenatal diagnosis possible?

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Maternal-Fetal Medicine

Background:

• Umbilical cord presentation, where the umbilical cord precedes the fetal presenting part, is a rare obstetric complication.
• Accurate antenatal diagnosis is crucial for appropriate management and improved perinatal outcomes.

Purpose of the Study:

• To report the incidence and management outcomes of antenatal diagnosed umbilical cord presentation.
• To evaluate the role of fetal ultrasound in identifying cord presentation.

Main Methods:

• Retrospective review of nine term patients diagnosed with cord presentation via fetal ultrasound.
• Analysis of delivery modes, confirmation of cord position, and perinatal outcomes.

Main Results:

• The incidence of antenatal cord presentation was 0.61% among referred patients.
• Seven of nine patients (77.8%) underwent cesarean section.
• Two vaginal deliveries occurred, one with spontaneous version and one complicated by stillbirth and cord prolapse.

Conclusions:

• Antenatal diagnosis of umbilical cord presentation is feasible with fetal ultrasound.
• Cesarean delivery is the predominant mode of birth for this condition.
• Vaginal delivery may be possible but carries risks, including cord prolapse and stillbirth.