Bako B, Chama C, Audu BM
Emergency obstetrics care in a Nigerian tertiary hospital: a 20 year review of umblical cord prolapse. [Journal Article]
Niger J Clin Pract 2009 Sep; 12(3):232-6.
CONTEXT: Umbilical cord prolapse is an obstetric emergency associated with high perinatal morbidity and mortality unless prompt delivery by the fastest and safest route is carried out.
OBJECTIVES: To determine the incidence of umbilical cord prolapse, predisposing factors, and fetal outcome.
STUDY DESIGN, SETTING AND
SUBJECTS: A 20 year retrospective study of all women who presented with umbilical cord prolapse at University of Maiduguri Teaching Hospital, Maiduguri, North-Eastern Nigeria.
RESULTS: During the study period there were 27,753 deliveries and 75 women had cord prolapse, giving the incidence of 1 in 370 deliveries (0.27%). Significantly more patients with non vertex presentation, twins and preterm delivery had cord prolapse. The highest occurrence was in those with unengaged presenting part (65.2%), spontaneous rupture of membrances (62.1%) and grandmultiparous women (57.6%). Caeserean section was carried out in 50% of cases, with mean decision-delivery interval of 77.1 +/- 21.7 minutes and 28/33 (84.9%) of babies delivered within 60 minute had normal Apgar scores. The Knee-chest position was most commonly used method of alleviating cord compression while arrangement for caesarean section was being made. The perinatal mortality was 27.3%.
CONCLUSION: umbilical cord prolapse is a brisk obstetric emergency with high perinatal morbidity and mortality unless prompt delivery is undertaken. Better communication and prompt response to emergency by the theatre team to reduce the decision-delivery interval would improve the perinatal outcome.
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