Predisposing and risk factors of umbilical cord prolapse

Altogether 117 deliveries (0.14%) out of 82 308 were complicated by umbilical cord prolapse (UCP) in the obstetrical department of Tampere University Central Hospital in the period 1962-81. The gross perinatal mortality rate in the present study was 16.2%, but during the last 5-year period the incidence of UCP (0.09%) as well as the perinatal mortality rate (5.9%) declined significantly. UCP seemed to be more prevalent during the first half of the year. The most prominent precipitating factors for the occurrence of UCP seemed to be abnormal presentation, multiple pregnancy, low birth weight, and multiparity. Amniotomy seemed not to increase the risk for UCP. Diminished perinatal mortality figures were closely associated with increased cesarean section rates in the management of deliveries complicated by UCP. Cesarean section is therefore recommended as the treatment of choice for deliveries complicated by UCP.