Umbilical Cord Prolapse and Evaluation of Maternal and Neonatal Outcomes

Abstract

Aim
 Umbilical cord prolapse(UCP) is the presence of the umbilical cord preceding ahead of the fetal presenting part with absent membranes through the cervical canal. Delayed delivery can even cause stillbirth. Despite improved obstetric care and liberal use of cesarean delivery, the incidence has not been decreased dramatically. The purpose of this study was to review the literature about umbilical cord prolapse and represent clinical experience to improve neonatal outcomes. 
 Material and Method
 A retrospective cohort study was conducted between October 2016-December 2019. Patients who experienced UCP were evaluated in terms of antenatal care, risk factors for UCP, labor progress, and neonatal outcomes.Maternal and neonatal outcomes of these patients were compared with the women who underwent emergent cesarean delivery due to acute fetal distress(AFD). 
 Results
 Forty-three pregnant women experienced UCP with an incidence of 11/10.000.The diagnosis was achieved by palpating the umbilical cord during the vaginal examination after detecting fetal bradycardia, severe deceleration or loss of reactivity in the Non-Stress Test. In two cases umbilical cord had seen in the vaginal introitus.The mean cervical dilatation of the patients was 5,4 cm.
 The number of women who underwent emergent cesarean, recruited in the study was 255. The APGAR scores were similar. 
 Conclusion 
 Emergent cesarean delivery could improve neonatal outcomes in patients diagnosed with UCP. Fetal wellbeing monitorization, especially in the one hour from rupture of fetal membranes, provides remarkable clues for UCP diagnosis. To improve neonatal outcomes, there should be one available operating theatre for emergent circumstances and a pediatrician for neonatal resuscitation.