[Frequency of cord prolapse: etiological factors and fetal prognosis in 47 cases in a health center].
Cord prolapse constitute an imprevisible accident of the period of labor and an important cause of perinatal mortality. The aim of our study was to determine the frequency of cord prolapse, its etiological factors and to evaluate fetal prognosis.


METHODS
Our study was done in the department of obstetric and gynecology of the Treichville university teaching hospital. It is a descriptive prospective study that covers 4 years period, from January 1st 1997 to December 31st 2000.


RESULTS
We did record 16.924 deliveries with 47 cases of cord prolapse representing a frequency of 0.28% The influencial factors for occurrence of cord prolapse were: prematurity, multiple pregnancy, dystocic presentations and spontaneous rupture of membranes. 28% of our patients had pregnancy not at term. Twin pregnancies represented 23.4% and in 91% of the cases, prolapsed concerned the second twin. Our rate of cord prolapse associated with vertex presentation was 23.4%; 42.5% in breech and 12.8% in the case of shoulder presentation. Spontaneous rupture of membranes was the most frequent type. In 61.7% of the cases, the delivery was done by caesarian section. Cord prolapse was greatly lethal for the fetus with 36.2% of death occurring before the 5th minute of life.


CONCLUSIONS
Umbilical cord prolapse is a grave obstetrical complication that compromises fetal prognosis.
Traore
Y
Y
Service de Gynécologie et d'Obstétrique-CHU Gabriel Touré-Bamako-Mali. drtraorey@yahoo.fr
Dicko
T F
TF
Teguete
B
B
Mulbah
J K
JK
Adjobi
R
R
N'Guessan
E
E
Tegnan
A
A
Kouyate
S
S
Kouakou
F
F
Anongba
S
S
Toure Coulibaly
K
K
D002585:Cesarean Section; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000145:classification / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011391:Prolapse; D011446:Prospective Studies; D014470:Umbilical Cord / Q000473:pathology*