Audit of cord prolapse management at King Abdulaziz University Hospital

Abstract EN

To assess the incidence of risk factors, management and outcome of umbilical cord prolapsed in a university hospital setting.

A retrospective chart review of women who had cord prolapsed at King Abdulaziz University Hospital over a period of eight years.

During the study period there were 49 cases of cord prolapsed (0.15 % incidence), which includes seven cases of cord presentation.

The mean maternal age was 30.31 years.

The majority was booked cases (71.4 %) and 5 were less than gravida 73.5 %.

In 10.2 % labor was induced.

The incidence of abnormal fetal presentation was 16 %, and in six patients the onset of labor was before 31 weeks.

The mean diagnosis to delivery interval was approximately 23 minutes ; with the exception of two vaginal deliveries and one ventouse delivery, all women underwent crash cesarean delivery.

There were 11 admissions to the NICU / SCBU and four mortalities, giving an overall perinatal mortality of 8.15 %.

In two of the mortality cases there were potentially avoidable factors ; the remaining ones were extremely premature babies.

Cord prolapsed is still a serious obstetric emergency.

The diagnosis to delivery interval is a crucial factor in the management of cord prolapsed.

All obstetric units should maintain continuous drills on crash cesarean deliveries.