Abstract
Objective: To determine the incidence and risk factors for umbilical cord prolapse and to
evaluate whether obstetrical interventions increase this risk.
Methods: A retrospective, cohort study of all intended vaginal deliveries in a single tertiary
university affiliated medical center (33 519 deliveries). Obstetrical and labor characteristics,
including labor interventions [as artificial rupture of membranes (ARM) and intrauterine
catheter insertion] and short-term pregnancy outcome were obtained. Primary outcome
measure was defined as abnormal umbilical cord pH57.2 and/or 5-min Apgar score 57.
Results: The rate of umbilical cord prolapse was 37/33 519 (0.11%); of them, 23 (62%) were
diagnosed after ARM, three cases (8%) were related to external cephalic version and three cases
(8%) were related to intrauterine catheter insertion. The rate of umbilical cord pH 57.2 and
5-min Apgar score57 was higher in the ARM group in comparison to women with spontaneous
rupture of membranes (30% versus 21%, p ¼ 0.8). There was no significant difference in mean
pH according to mode of delivery. All neonates were discharged within 8 d of delivery with
good neonatal outcome and the rate of maternal complications was low.
Conclusion: Prompt delivery in cases of umbilical cord prolapse is associated with favorable
pregnancy outcome.