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The mortality and morbidity associated with umbilical cord prolapse
1Department of Obstetrics and Gynaecology, John Radcliffe NHS Trust, Oxford, UK.
British Journal of Obstetrics and Gynaecology
|October 1, 1995
Summary
Cord prolapse, a rare obstetric emergency, has a stable incidence. Despite concerning fetal monitoring, outcomes are often favorable, with mortality mainly due to prematurity and congenital issues, not birth asphyxia.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Perinatal Epidemiology
Background:
- Cord prolapse is a critical obstetric complication requiring prompt management.
- Understanding its impact on fetal well-being and long-term outcomes is crucial for improving care.
Purpose of the Study:
- To investigate the management strategies for cord prolapse.
- To assess the associated morbidity and mortality rates in affected neonates.
Main Methods:
- Retrospective study of 132 babies born after cord prolapse (1984-1992).
- Analysis included survival rates, Apgar scores, cord blood gas values, and incidence of major handicap at three years.
- Data sourced from Oxford Obstetric Data System and Register of Early Childhood Impairments.
Main Results:
- Cord prolapse incidence was 1 in 426 births.
- Perinatal mortality rate was 91 per 1000 births, with few deaths attributed to birth asphyxia.
- Only one survivor out of 120 experienced a major neurological handicap; 41% of diagnoses aided by cardiotocography.
Conclusions:
- Cord prolapse incidence remains stable despite evolving obstetric practices.
- Fetal outcomes are generally better than anticipated, despite concerning fetal monitoring results.
- Mortality is primarily linked to congenital anomalies and prematurity, rather than birth asphyxia.