[The significance of the problem of umbilical cord prolapse during delivery]

The authors aimed at studying the significance of cord prolapse in modern obstetrics. 18836 deliveries were studied. These deliveries occurred during a 7 year period (1990-1996) and a rate of cord prolapse of 0.106% was found (1 case in 941.8 deliveries). Cord prolapse was found in 20 deliveries of which 16 were singleton pregnancies and 4 multiple. 7 of the women were nulliparous and 13 multiparous. The majority of patients were of gestational age 38-41 weeks--13 (65.0%) 4 (20.0%) were between 30-37 gestational weeks and 3 (15.0%) were 42 gestational weeks. Of the singleton pregnancies only one fetus was in a transverse lie, 8 were breech presentations and 7 vertex presentations. Delivery was accomplished by cesarean section in 2 (45.0%) cases. Of the 8 breeches 3 were delivered by CS, 4 vaginal manual delivery and one (1) by manual extraction. All multiple pregnancies were delivered vaginally normally. Of the singleton pregnancies only 2 were under 2000 g weight, Perinatal infant mortality rate in this group was 291.67% (7 of 24). Still births were 2 and they occurred intrapartially: one was a vertex presentation after refusal of CS, and the second--after breech extraction (1500 g birth weight). The authors conclude that in order to reduce the rate of cord prolapse indications for CS should be precisely revised for multiple pregnancies breech presentation.