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Presentation and perinatal outcome following umbilical cord prolapse in Ilorin

Background: Umbilical cord prolapse remains one of the most common obstetric emergencies associated with high foetal and neonatal morbidity and mortality. Materials and Methods: A descriptive (retrospective) study was conducted on all women who were managed for umbilical cord prolapse over a 4-year period. The medical records of all eligible women were retrieved, and relevant information was extracted. The main outcome measures were perinatal outcome and the need for neonatal intensive care. The results were represented using simple descriptive methods. Results: There were 56 women with umbilical cord prolapse out of the 14,892 deliveries with a prevalence of 0.38%. A single risk factor was present in 39 (72.2%) women, and breech presentation [12 (22.2%)] was the most common risk factor. In addition, 42 (77.8%) women presented with live foetuses with palpable umbilical cord pulsation in the first stage of labour and subsequently had emergency caesarean deliveries. The diagnosis-to-delivery interval for live foetuses was less than 30 min in seven women (16.7%) and between 30 and 60 min in 34 women (80.9%). All women who had foetal death at presentation subsequently had vaginal delivery. A total of 23 (54.8%) neonates were admitted into the neonatal intensive care unit mostly for perinatal asphyxia [16 (69.6%)], whereas 6 (26.1%) suffered early neonatal death. The perinatal mortality rate for the study was 333/1000. Conclusion: Modern antenatal care, early presentation and complication readiness for prompt emergency care by the health facilities will improve perinatal outcome from cord prolapse.