Kalu C A, Umeora O U J
Department of Obstetrics and Gynaecology, Ebonyi State University Teaching Hospital, Abakaliki, Nigeria.
Niger J Clin Pract. 2011 Oct-Dec;14(4):413-7. doi: 10.4103/1119-3077.91746.
The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse.
During the period of the study (from July 1, 2001 and June 30, 2007), forty-six cases of umbilical cord prolapse were identified from the labor ward record and analyzed retrospectively. Associations between cord prolapse and potential risk factors were evaluated by means of the odds ratio.
During the period of the study, 46 cases of cord prolapse were encountered out of 10,080 deliveries which was 0.46% of all deliveries. Of the 46 fetuses with umbilical cord prolapse 32.6% had a fetal weight of less than 2.5 kg compared with 15.2% for fetuses in control group (P<0.012). The umbilical cord prolapse occurred in association with breech presentation eleven times (23.9%) and transverse presentation seven times (15.2%). The occurrence of breech presentation among the control cases was 4.3% (P<0.00031), and that of transverse lie was 4.4% (P<0.02007). Among the women that had cord prolapse, 47.8% had unbooked pregnancies compared with the control group with 14.5% (P<0.0000033). Multiparity accounted for 78.3% in the cord prolapse cases and 68.1% in the controls (P=0.19). The perinatal mortality rate was 413/1000. (41.3%), compared to the perinatal mortality of 58/1000 for the control group.
Our findings in this study has confirmed an association between increased risk of umbilical cord prolapse and abnormal fetal presentation, low birth weight and unbooked status. It is therefore suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care and this will enhance the early identification of these risk factors and an appropriate management instituted to reduce perinatal mortality.
本研究的目的是确定与脐带脱垂相关的风险因素，并记录脐带脱垂病例的围产期结局。
在研究期间（2001年7月1日至2007年6月30日），从产房产科记录中识别出46例脐带脱垂病例，并进行回顾性分析。通过比值比评估脐带脱垂与潜在风险因素之间的关联。
在研究期间，10080例分娩中有46例发生脐带脱垂，占所有分娩的0.46%。46例脐带脱垂胎儿中，32.6%的胎儿体重低于2.5kg，而对照组胎儿的这一比例为15.2%（P<0.012）。脐带脱垂与臀位产相关11次（23.9%），与横位产相关7次（15.2%）。对照组中臀位产的发生率为4.3%（P<0.00031），横位产的发生率为4.4%（P<0.02007）。在发生脐带脱垂的女性中，47.8%的孕妇未进行产前登记，而对照组为14.5%（P<0.0000033）。经产妇在脐带脱垂病例中占78.3%，在对照组中占68.1%（P=0.19）。围产期死亡率为413/1000（41.3%），而对照组的围产期死亡率为58/1000。
我们在本研究中的发现证实了脐带脱垂风险增加与异常胎位、低出生体重和未进行产前登记之间的关联。因此，建议鼓励孕妇在孕期尽早登记进行产前检查，这将有助于早期识别这些风险因素，并采取适当的管理措施以降低围产期死亡率。
