Increasing maternal age and parity as well as prematurity were the factors significantly associated with CS. Fetomaternal outcome was comparable between vaginal and abdominal deliveries, despite the high CS rate. Non-reassuring cardiotocography was the most common indication. Secondary tests for evaluation of fetal well being might help to reduce the high CS rate.

Women included in the study did not want frequent visits to antenatal clinic. Efforts should be made to provide information about labor, breast-feeding and contraception.

Umbilical cord prolapse occurs when a loop of cord is present below the presenting part when the amniotic membranes are ruptured. The incidence is 0.2% of total births. The case presented here is unusual because the definition of cord prolapse cannot be applied to it and the lady did not complain of any history of urinary incontinence or hematuria. The presentation of umbilical cord through maternal urethra led to the speculation of an opening between the anterior uterine wall and the bladder. Fetal demise was diagnosed by abdominal ultrasound. At laprotomy, a communication was found between the bladder and the uterus thus letting the cord traverse through the bladder.