Umbilical Cord Prolapse and Perinatal Outcomes in a Tertiary Hospital in Yenagoa, South-South Nigeria: A 5-Year Review

Abstract

Background: Umbilical cord prolapse is an obstetric emergency when the foetus is still alive, and it is associated with high foetal morbidity and mortality. If umbilical cord prolapse occurs outside the hospital, mortality rate can be as high as 44% – 70%, and as low as 3% when it occurs in the hospital. Objective: To determine the incidence of umbilical cord prolapse and the perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over 5 years. Materials and Methods: This retrospective survey was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: Forty-one women had umbilical cord prolapse out of 4,571 deliveries, giving a case incidence rate of 8.9 per 1,000 deliveries. About three-quarters (75.6%) of the women were multiparous. A fifth (21.9%) of the foetuses died in-utero, while 27 (65.9%) babies survived. Five (15.6%) babies had severe birth asphyxia, and died (early neonatal death) in the special care baby unit. Decision-to-delivery interval was ≤ 30 minutes in only 12.5% of patients. Conclusion: Umbilical cord prolapse is associated with significant perinatal morbidity and mortality. Prompt diagnosis and intervention are very key in preventing adverse perinatal outcomes.