Umbilical cord prolapse: A true obstetrical emergency

Barnett, William M.

doi:10.1016/0736-4679(89)90261-8

Cited by 10 publications

(8 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 The sonographic diagnosis of funic presentation has been reported by several authors, all of whom recommend cesarean section, as a management strategy. 1–3…”

mentioning

confidence: 99%

New Indication for an Established Procedure: Cervical Cerclage for Prevention of Umbilical Cord Prolapse

Petrikovsky

Terrani

Dillon

2022

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

Objective: Funic presentation is a risk factor for umbilical cord prolapse. In the majority of cases, umbilical cord prolapse is an obstetric emergency. Currently there is no strategy to prevent umbilical cord prolapse in patients with funic presentation. Placing a third trimester cervical cerclage was proposed, as a mechanical barrier of prolapse, in women with funic presentation. Materials and Methods: Twelve patients with funic presentation, detected between 23 and 34 weeks of gestation, were included in the study. Patients were informed that although cervical cerclage have been widely used in obstetrics, it had not been offered in patients with funic presentation. Gestational age at delivery, mode of delivery, location of umbilical cord at birth, presence or absence of umbilical cord prolapsed, and neonatal condition at birth were recorded in all cases. Results: Patients’ age varied from 21 to 40 years, mean of 28 ± 6.2 years, and gestational age at the time of diagnosis of funic presentation varied from 26 to 34 weeks of pregnancy. All patients were seen weekly after the cervical cerclage placement to assess the umbilical cord location. Seven patients had vertex presentation, four had breech presentation, and one had transverse lie presentation. A follow-up sonogram of the umbilical cord revealed the following: funic presentation was persistent throughout the entire pregnancy in five patients, disappeared in four, and became intermittent in three. The delivery mode was as follows: cesarean section was performed in eight patients (five with persistent funic presentation, two with intermittent, and one with resolved funic presentation because of failure to progress in labor). There were five patients who delivered vaginally. Funic presentation was confirmed in all patients who underwent cesarean sections. None of the patients had had an umbilical cord prolapse. Conclusion: In view of high perinatal mortality of umbilical cord prolapses, placement of cervical cerclage could be added to obstetric armamentarium in patients with funic presentation, after proper counseling.

show abstract

“…5 The sonographic diagnosis of funic presentation has been reported by several authors, all of whom recommend cesarean section, as a management strategy. 1–3…”

mentioning

confidence: 99%

New Indication for an Established Procedure: Cervical Cerclage for Prevention of Umbilical Cord Prolapse

Petrikovsky

Terrani

Dillon

2022

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

show abstract

“…It currently consists of frequent sonographic assessments, nonstress tests, and an early delivery, which aims to detect funic presentation, after the fact. 1,3 This study presents a new approach, which is a third trimester cervical cerclage, for the mechanical prevention of umbilical cord prolapse, in women with funic presentation. Cervical cerclage provides a mechanical obstruction of the cervix, which will not permit the presenting umbilical cord to prolapse.…”

mentioning

confidence: 99%

“…The concern with an umbilical cord prolapse is that pressure, on the umbilical cord, from the fetus will compromise blood flow and oxygenation. 1 An umbilical cord prolapse is a rare event and can complicate 0.17%–0.62% of all pregnancies. 1 Although infrequent, it has been associated with significant perinatal morbidity and mortality.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Can Cervical Cerclage Prevent Umbilical Cord Prolapse in Patients with Funic Presentation?

Petrikovsky

Terrani²,

Dillon³

et al. 2021

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

Objective: Umbilical cord prolapse is a rare event complicating 0.17%–0.62% of all pregnancies. Funic presentation is a known risk factor for umbilical cord prolapse. Currently, there is no strategy to prevent umbilical cord prolapse in patients with funic presentation. The novel technique used is placement of late cervical cerclage to create a mechanical barrier and prevent an umbilical cord prolapse. Material and Methods: Six patients with a sonographically detected funic presentation were included in the study. Funic presentation was defined as the sonographic presence of the umbilical cord below the presenting part using both transabdominal and transvaginal sonography. Cord prolapse was defined as an umbilical cord seen or palpated below the presenting part. Cervical cerclage was placed in patients with persistent funic presentations, which is the detection of the umbilical cord below the presenting part, on two or more sonograms at least a week apart. Results: Cervical cerclages were placed in six patients with funic presentation between 28 and 34 weeks of gestation without immediate complications. All patients were delivered by a cesarean section between 35 and 38 weeks of pregnancy. None experienced umbilical cord prolapse. Funic presentation was confirmed at birth in all cases. Apgar scores varied between 7 and 10. Conclusion: It appears that cervical cerclage may be an effective measure to prevent umbilical cord prolapse in cases of known persistent funic presentation.

show abstract

“…Umbilical cord prolapse is a rare event complicating 0.17-0.62% of all pregnancies [1]. Although infrequent, the associated perinatal mortality is high, resulting in an obstetrical emergency and at times an obstetrical catastrophe.…”

Section: Introductionmentioning

confidence: 99%

Does Cord Presentation on Ultrasound Predict Cord Prolapse?

Ezra

Strasberg

Farine³

2003

Gynecol Obstet Invest

View full text Add to dashboard Cite

Objective: To study the association of umbilical cord presentation found on antenatal ultrasound and the incidence of cord prolapse in labor. Study Design: We reviewed the antenatal records of all deliveries in the Mount Sinai Hospital in a 5-year period and conducted two separate retrospective studies. In the first study we reviewed the antenatal sonograms of all women with proven cord prolapse for cord presentation (study A). In the second study we reviewed the obstetrical outcome of pregnancies where sonographic cord presentation was identified in the third trimester of pregnancy (study B). Results: In study A, 16,551 delivery records were reviewed and 42 patients were found to have had clinical cord prolapse (0.25%). Sonograms were available for 16 of these 42 patients. Only 2 of them (12.5%) had cord presentation on ultrasound scan. In study B, cord presentation was reported in 13 of 8,122 consecutive sonograms (0.16%). Six of these patients (6/13, 46%) had been scanned once. Three required cesarean delivery for malpresentation and cord presentation on ultrasound (3/13, 23%), while the other 3 had uncomplicated vaginal deliveries (23%). The remaining 7 patients had repeat scans which revealed persistent cord presentation in 3 (23%). All 3 underwent cesarean delivery, 1 following cord prolapse. The other 4 spontaneously converted to vertex with resolution of cord presentation as proven at delivery (31%). Conclusion: Cord presentation and cord prolapse are not synonymous. Documented cord presentation during the third trimester necessitates repeat scans and intrapartum sonographic assessment to determine the mode of delivery.

show abstract

Umbilical cord prolapse: A true obstetrical emergency

Cited by 10 publications

References 4 publications

New Indication for an Established Procedure: Cervical Cerclage for Prevention of Umbilical Cord Prolapse

New Indication for an Established Procedure: Cervical Cerclage for Prevention of Umbilical Cord Prolapse

Can Cervical Cerclage Prevent Umbilical Cord Prolapse in Patients with Funic Presentation?

Does Cord Presentation on Ultrasound Predict Cord Prolapse?

Contact Info

Product

Resources

About