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AJP Reports Apr 2018The aim of the study was to examine the association between cervical exam at the time of artificial rupture of membranes (AROM) and cord prolapse. We conducted a...
The aim of the study was to examine the association between cervical exam at the time of artificial rupture of membranes (AROM) and cord prolapse. We conducted a retrospective cohort study using the data from the Consortium on Safe Labor. We included women with cephalic presentation and singleton pregnancies at ≥ 23 weeks' gestation who underwent AROM during the course of labor. Multivariable logistic regression was used to calculate the adjusted odds ratio (aOR) with 95% confidence interval (95% CI), controlling for prespecified covariates. Of 57,204 women who underwent AROM, cord prolapse occurred in 113 (0.2%). Compared with dilation 6 to 10 cm + station ≥ 0 at the time of AROM, <6 cm + any station and 6-10 cm + station ≤ -3 were associated with increased risks of cord prolapse (<6 cm + station ≤ -3 [aOR, 2.29; 95% CI, 1.02-5.40]; <6 cm + station -2.5 to -0.5 [aOR, 2.34; 95% CI, 1.23-4.97]; <6 cm + station ≥ 0 [aOR, 3.31; 95% CI, 1.39-8.09]; and 6-10 cm + station ≤ -3 [aOR, 5.47; 95% CI, 1.35-17.48]). Cervical dilation < 6 cm with any station and 6 to 10 cm with station ≤ -3 were associated with a higher risk of cord prolapse.
PubMed: 29755833
DOI: 10.1055/s-0038-1649486 -
Saudi Medical Journal Jul 2003To review the peripartum clinical course of patients whose pregnancies were complicated by umbilical cord prolapse and to evaluate its impact on neonatal outcome.
OBJECTIVE
To review the peripartum clinical course of patients whose pregnancies were complicated by umbilical cord prolapse and to evaluate its impact on neonatal outcome.
METHODS
All cases of cord prolapse managed in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between 1990-2000 were identified. There were 111 patients identified among 55,789 deliveries. Each maternal and fetal chart was reviewed for parity, age, gestational age, fetal presentation, status of membranes, time from diagnosis to delivery, mode of delivery, baby weight, Apgar scores and cord blood hydrogen ion concentration (PH). The data collected was analyzed using Gold Stat Software Package, and statistical significance was established by using analysis of variance and Chi-square.
RESULTS
The incidence of cord prolapse was found to be one in 503 cases (1.99 per thousand deliveries) in our study. Seventy-two (64.9%) of the fetuses were in vertex presentation and 39 (35.1%) were non-vertex, including breech and transverse presentations. Ninety one point nine percent were singletons and 8% were twins. At the time of diagnosis in 15 (13.5%) membranes were artificially ruptured and in 96 (86.5%), they were spontaneously ruptured. The cervix was fully dilated in 10% and minimally dilated in 100 (90%). Regarding mode of delivery, 7 (6.5%) were vaginal deliveries and 104 (93.5%) were cesarean sections. The interval from diagnosis to delivery ranged from 10 minutes to >20 minutes. Six (5.4%) of the babies were delivered in 10 minutes, 49 (44.1%) in 20 minutes and 56 (50.5%) in more than 20 minutes. Apgar score was less than 7 in 44 (39.6%) of the babies at one minute and in 5 (4.5%) of the babies at 5 minutes. Cord PH was less than 7 in 2 (1.8%) cases and more than 7 in 109 (98.2%). Forty-one (36.9%) of the babies were admitted in neonatal intensive care unit. There was no perinatal mortality in our study group.
CONCLUSION
In our review, we found that cord prolapse is not associated with higher rates of perinatal mortality or morbidity and our study supports clinical management of cord prolapse by cesarean section. The interval from diagnosis to delivery may not be the only determinant of neonatal outcome.
Topics: Adult; Apgar Score; Female; Fetal Diseases; Humans; Pregnancy; Pregnancy Outcome; Prolapse; Saudi Arabia; Umbilical Cord
PubMed: 12883608
DOI: No ID Found -
Lancet (London, England) Jan 1996
Topics: Cesarean Section; Female; Humans; Infant Mortality; Infant, Newborn; Obstetric Labor Complications; Pregnancy; Prolapse; Umbilical Cord
PubMed: 8538343
DOI: 10.1016/s0140-6736(96)90207-x -
Gynecologic and Obstetric Investigation 2003To study the association of umbilical cord presentation found on antenatal ultrasound and the incidence of cord prolapse in labor.
OBJECTIVE
To study the association of umbilical cord presentation found on antenatal ultrasound and the incidence of cord prolapse in labor.
STUDY DESIGN
We reviewed the antenatal records of all deliveries in the Mount Sinai Hospital in a 5-year period and conducted two separate retrospective studies. In the first study we reviewed the antenatal sonograms of all women with proven cord prolapse for cord presentation (study A). In the second study we reviewed the obstetrical outcome of pregnancies where sonographic cord presentation was identified in the third trimester of pregnancy (study B).
RESULTS
In study A, 16,551 delivery records were reviewed and 42 patients were found to have had clinical cord prolapse (0.25%). Sonograms were available for 16 of these 42 patients. Only 2 of them (12.5%) had cord presentation on ultrasound scan. In study B, cord presentation was reported in 13 of 8,122 consecutive sonograms (0.16%). Six of these patients (6/13, 46%) had been scanned once. Three required cesarean delivery for malpresentation and cord presentation on ultrasound (3/13, 23%), while the other 3 had uncomplicated vaginal deliveries (23%). The remaining 7 patients had repeat scans which revealed persistent cord presentation in 3 (23%). All 3 underwent cesarean delivery, 1 following cord prolapse. The other 4 spontaneously converted to vertex with resolution of cord presentation as proven at delivery (31%).
CONCLUSION
Cord presentation and cord prolapse are not synonymous. Documented cord presentation during the third trimester necessitates repeat scans and intrapartum sonographic assessment to determine the mode of delivery.
Topics: Adult; Cesarean Section; Delivery, Obstetric; Female; Humans; Pregnancy; Pregnancy Outcome; Prolapse; Retrospective Studies; Ultrasonography, Prenatal; Umbilical Cord
PubMed: 12867760
DOI: 10.1159/000072323 -
The Journal of Pathology and... Jul 1964
Topics: Apatites; Calcinosis; Electrons; Intervertebral Disc; Intervertebral Disc Displacement; Microscopy; Microscopy, Electron; Neurologic Manifestations; Radiography; Reflex; Reflex, Stretch; Spinal Cord Compression; Surgical Procedures, Operative; Tendons; Thoracic Vertebrae; X-Ray Diffraction
PubMed: 14194972
DOI: 10.1002/path.1700880120 -
The Journal of Maternal-fetal &... Jan 2014To determine the incidence and risk factors for umbilical cord prolapse and to evaluate whether obstetrical interventions increase this risk.
OBJECTIVE
To determine the incidence and risk factors for umbilical cord prolapse and to evaluate whether obstetrical interventions increase this risk.
METHODS
A retrospective, cohort study of all intended vaginal deliveries in a single tertiary university affiliated medical center (33 519 deliveries). Obstetrical and labor characteristics, including labor interventions [as artificial rupture of membranes (ARM) and intrauterine catheter insertion] and short-term pregnancy outcome were obtained. Primary outcome measure was defined as abnormal umbilical cord pH <7.2 and/or 5-min Apgar score <7.
RESULTS
The rate of umbilical cord prolapse was 37/33 519 (0.11%); of them, 23 (62%) were diagnosed after ARM, three cases (8%) were related to external cephalic version and three cases (8%) were related to intrauterine catheter insertion. The rate of umbilical cord pH <7.2 and 5-min Apgar score <7 was higher in the ARM group in comparison to women with spontaneous rupture of membranes (30% versus 21%, p = 0.8). There was no significant difference in mean pH according to mode of delivery. All neonates were discharged within 8 d of delivery with good neonatal outcome and the rate of maternal complications was low.
CONCLUSION
Prompt delivery in cases of umbilical cord prolapse is associated with favorable pregnancy outcome.
Topics: Apgar Score; Bradycardia; Catheters; Cohort Studies; Delivery, Obstetric; Extraembryonic Membranes; Female; Fetal Diseases; Hospitals, University; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Intensive Care Units, Neonatal; Labor, Induced; Pregnancy; Prolapse; Retrospective Studies; Risk Factors; Umbilical Cord; Version, Fetal
PubMed: 23617536
DOI: 10.3109/14767058.2013.799651 -
British Journal of Obstetrics and... Oct 1995To examine the management of cord prolapse and its morbidity and mortality.
OBJECTIVE
To examine the management of cord prolapse and its morbidity and mortality.
DESIGN
Retrospective study of consecutive babies born after cord prolapse, identified using the Oxford Obstetric Data System, and those with registered handicap, identified by the Oxford Region Register of Early Childhood Impairments.
SETTING
District maternity hospital managing more than 6000 deliveries annually.
SUBJECTS
One hundred and thirty-two babies born after the identification of cord prolapse in the John Radcliffe Hospital between January 1984 and December 1992.
MAIN OUTCOME MEASURES
Survival rates, condition at birth assessed by Apgar scores at 1 and 5 minutes and blood gas values on cord blood samples, and incidence of major handicap at three years of age.
RESULTS
The incidence of cord prolapse was 1 in 426 total births. There were six stillbirths and six neonatal deaths. One baby died as a result of birth asphyxia. The uncorrected perinatal mortality rate was 91 per 1000. Of 120 survivors, only one baby was known to suffer a major neurological handicap. Electronic cardiotocographs aided the diagnosis of cord prolapse in 41% of cases. Apgar scores were better with a shorter diagnosis to delivery interval, but cord gas results did not correlate well with Apgar scores or the diagnosis to delivery interval.
CONCLUSIONS
Cord prolapse occurs with a relatively stable incidence in this population irrespective of changes in obstetric practices. Despite the high incidence of ominous cardiotocographs, low Apgar scores and acidaemia on blood gas analysis, the fetal outcome is not as poor as might be expected and mortality is predominantly attributable to congenital anomalies and prematurity rather than birth asphyxia.
Topics: Cardiotocography; Delivery, Obstetric; Female; Fetal Diseases; Humans; Incidence; Labor Presentation; Pregnancy; Pregnancy Outcome; Prolapse; Retrospective Studies; Survival Rate; Umbilical Cord
PubMed: 7547741
DOI: 10.1111/j.1471-0528.1995.tb10850.x -
BMJ (Clinical Research Ed.) May 1999
Review
Topics: Breech Presentation; Delivery, Obstetric; Dystocia; Female; Humans; Labor Presentation; Pregnancy; Pregnancy, Multiple; Prenatal Care; Prolapse; Umbilical Cord
PubMed: 10221949
DOI: 10.1136/bmj.318.7192.1192 -
The Journal of Urology Sep 1990Among the anomalies of testicular descent exstrophy of the testis appears to be the most rare. We describe a full-term male newborn with the right testis and spermatic...
Among the anomalies of testicular descent exstrophy of the testis appears to be the most rare. We describe a full-term male newborn with the right testis and spermatic cord prolapsed from a skin defect at the neck of the scrotum. The cause of the anomaly is unknown.
Topics: Genital Diseases, Male; Humans; Infant, Newborn; Male; Prolapse; Spermatic Cord; Testis
PubMed: 2388337
DOI: 10.1016/s0022-5347(17)39566-6 -
Medecine Et Sante Tropicales 2015Umbilical cord prolapse is an obstetrical emergency that is life-threatening for the fetus. This retrospective cross-sectional study examined cases of pulsating...
UNLABELLED
Umbilical cord prolapse is an obstetrical emergency that is life-threatening for the fetus. This retrospective cross-sectional study examined cases of pulsating umbilical cord prolapses at our level-3 maternity unit over the past three years and sought to assess their prognosis. Cord prolapse occurred in 0.27% of deliveries. The women's mean age was 28 years, and 51% of the women were multiparous. Cesarean deliveries were performed in 96% of cases. Factors affecting neonatal outcome were the degree of cord prolapse (p = 0.0002981) and the appearance of amniotic fluid (p = 0.004078). The neonatal complications included admission to neonatal intensive care (33%), perinatal asphyxia (31%), prematurity (29%), neonatal infection (4%), and neonatal mortality (10%).
CONCLUSION
The fetus must be delivered rapidly, especially when the umbilical cord drops outside the mother's body and the amniotic fluid is meconial.
Topics: Adult; Cross-Sectional Studies; Female; Hospitals; Humans; Infant, Newborn; Infant, Newborn, Diseases; Madagascar; Pregnancy; Pregnancy Complications; Prognosis; Prolapse; Retrospective Studies; Umbilical Cord
PubMed: 26742556
DOI: 10.1684/mst.2015.0454