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Term pregnancy with umbilical cord prolapse.

Abstract：

OBJECTIVE:To investigate the incidence, management, and perinatal and long-term outcomes of term pregnancies with umbilical cord prolapse (UCP) at Mackay Memorial Hospital, Taipei, from 1998 to 2007. MATERIALS AND METHODS:For this retrospective study, we reviewed the charts, searched a computerized birth database, and contacted the families by telephone to acquire additional follow-up information. RESULTS:A total of 40 cases of UCP were identified among 40,827 term deliveries, an incidence of 0.1%. Twenty-six cases (65%) were delivered by emergency cesarean section (CS). Of the neonates, 18 had an Apgar score of <7 at 1 minute, 10 of these scores being sustained at 5 minutes after birth, and three infants finally died. Eleven UCPs occurred at the vaginal delivery of a second twin, and nine with malpresentation. All of the infants who had good perinatal outcomes also had good long-term outcomes. Poor perinatal outcomes occurred in cases where there was a delayed diagnosis, or an inability to carry out an emergency CS or a prompt vaginal delivery. CONCLUSION:Early detection of UCP and expeditious delivery are crucial to good perinatal outcomes. An emergency CS remains the mainstream management. Multiparous women whose cervixes are nearly fully dilated and who are expecting babies relatively smaller than their elder brothers or sisters born vaginally may still have vaginal deliveries managed by well-experienced birth teams, with good perinatal outcomes. Otherwise, vaginal delivery is not recommended and CS is the wiser choice.

journal_name

Taiwan J Obstet Gynecol

journal_title

Taiwanese journal of obstetrics & gynecology

authors

Huang JP,Chen CP,Chen CP,Wang KG,Wang KL

doi

10.1016/j.tjog.2012.07.010

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

375-80

issue

3

eissn

1028-4559

issn

1875-6263

pii

S1028-4559(12)00124-6

journal_volume

51

pub_type

杂志文章

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