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  Chapter 14a Cord presentation and prolapse 

Disclaimer | Introduction | Definitions | Literature review | Risk factors | Diagnosis | Management | Counselling | References | Last reviewed
 
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Literature review

>  The incidence of cord prolapse varies between 0.1 – 0.6 % (RCOG 2008)

>  In South Australia in 2008, cord prolapse occurred in 0.1 % of all confinements (Chan et al. 2009)

>  One large study reported a perinatal mortality rate of 91 / 1000. Preterm birth and congenital malformations accounted for the majority of adverse outcomes in the hospital setting and birth asphyxia was also associated with cord prolapse (RCOG 2008)

>  Asphyxia may also result in hypoxic-ischaemic encephalopathy and cerebral palsy (RCOG 2008)

>  A finding of cord presentation on ultrasound is associated with an increased risk of cord prolapse; however, the majority of sonographic cord presentations are not followed by cord prolapse (Ezra et al. 2003)

>  A recent retrospective study reported a higher incidence of cord prolapse among women who undergo induction of labour (artificial rupture of the membranes) (Boyle and Katz 2005)

>  Cord presentation / prolapse is more likely to occur after artificial rupture of the membranes or sudden spontaneous rupture of the forewaters (with malpresentation or high presenting part) than in association with a hindwater leak (Steer and Danielian 2006)

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