Fetal outcome in umbilical cord prolapse in Jos, Nigeria
AbstractBackground: Cord prolapse is one of the obstetric emergencies in labour, posing a life-threatening emergency for the fetus. Timely delivery at detection with a live fetus is the hallmark of good clinical management to reduce the high perinatal morbidity and mortality in the fetus.
Objective: To determine the incidence of cord prolapse, predisposing factors and fetal outcome of the cases of cord prolapse managed in the Jos University Teaching Hospital (JUTH).
Study Design: A review of the fetal outcome of thirty-five (35) cases of cord prolapse managed at the JUTH, Jos, Nigeria from January 1999 to December 2003.
Results: There were 12,536 deliveries with 35 cases of cord prolapse, giving an incidence of 0.28%, or 1 in 358 deliveries. The highest incidence occurred in women aged 30-34 years. Cord prolapse was seen to be mainly a problem of multiparous women, 96.8%. Prematurity was the highest contributing factor 12 (30.0%), followed by twin pregnancy 9 (22.5%). About 57% of the babies were dead on presentation to the hospital, mainly from patients booked outside JUTH. One baby with severe birth asphyxia died in the early neonatal period. Perinatal mortality was 629 per 1,000 deliveries.
Conclusion: The perinatal mortality in the cases of cord prolapse is still high. Most fetal deaths were from patients that booked outside the hospital, presenting with intrauterine fetal death. The un-booked patient with cord prolapse is most likely to present with an intrauterine fetal death.
Keywords: cord prolapse, fetal outcome, labour
Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 30-33
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