OBJECTIVE: Umbilical cord prolapsus (UCP) is a rare emergency event that complicates pregnancy. Although it occurs rarely, the increment of maternal-fetal morbidity and mortality can be encountered in pregnancies complicated by UCP. The decrement in the rate of this complication can be obtained with early diagnosis and appropriate treatment. The aim of this study is to determine the fetal-maternal morbidity and mortality rates of pregnancies complicated with umbilical cord prolapsus. Design: Retrospective analysis. Setting: Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology Patients: Thirteen vaginal deliveries complicated with umbilical cord prolapsus in 2152 vaginal delivery which were performed in Hacettepe University, Department of Obstetrics and Gynecology through January 1999 to January 2002. Main outcome measures: Fetal-maternal morbidity and mortality RESULTS: There were 13 cases complicated by UCP during this 3 years period. The total number of normal vaginal deliveries during this time interval was 2152 and the incidence of UCP was %0,6. The mean age, the mean gestational age and the mean weight of neonates were 30,8±6,5 (year), 36,8±3,4 (week) and 2986,9±775,1 (gram) respectively. The UCP was encountered after the artificial amniotomy in 11 of 13 cases. Although 3 of 13 (13.3%) cases were under 37 weeks according to gestational age, only one neonate was less than 2500 gram. The malpresentation rate was 2/13 (%15.4) (breech-breech). The mean Apgar score of neonates at 5. minutes after the delivery was 8,4±2,5 minutes (range=2-10). The mean time interval between the diagnosis of UCP and delivery of all cases was 8,3±3,1 minutes (range 5-15). While the mean time interval of cases occurred in working hours was 7,1±1,4 minutes, it was 12,3±3,7 minutes in case of that in non-working hours. There was no maternal-fetal mortality except one neonate with ischemic encephalopathy. CONCLUSION: Although the prevention of UCP may not be possible in all cases; the sufficient setup, the early diagnosis and appropriate fast treatment of UCP may decrease the fetal-maternal morbidity and mortality.

Keywords: fetal asphyxia, maternal morbidity, umbilical cord prolapsus