Prolapse of the umbilical cord: a study of 69 cases.

Prolapse of the umbilical cord occurred 69 times in 30112 deliveries. The incidence was higher in abnormal presentations, particularly in compound presentation (11.1%), and in breech presentation (2.9%), especially when these occurred in association with prematurity. Twenty-five (36.2%) of the 69 infants died; 21 of these were dead at the time of diagnosis of cord prolapse, two died in the neonatal period of respiratory distress syndrome, and two died from complications of breech extraction. Reduction in perinatal mortality will be possible only if early diagnosis of cord prolapse can be made by means of vaginal examination or fetal heart monitoring, and the birth trauma associated with difficult vaginal delivery prevented.