title: Retrospective evaluation of risk factors and perinatal outcome of umbilical cord prolapse during labor.
abstract: OBJECTIVE
  Umbilical cord prolapse has a reported prevalence of 0.1-0.6%. In previous studies, risk factors for umbilical prolapse have been identified as multiparity, preterm delivery, non-vertex presentation, and obstetric manipulation for labor induction. In the present study, we aimed to investigate the risk factors for umbilical cord prolapse and to determine the factors that may relate to neonatal morbidity in these patients.
  
  
  METHODS
  This study consisted of recorded cases of umbilical cord prolapse at Dr Zekai Tahir Burak Research and Training Hospital between January 2008 and May 2013. Clinical and demographic data were obtained by reviewing the patients' medical records. Student's t test was performed for parametric variables between groups, and a Chi-square test was performed for nonparametric variables between groups. A logistic regression was performed to investigate the effects of clinical parameters such as gestational age, diagnosis to delivery interval, and fetal presentation on neonatal morbidity.
  
  
  RESULTS
  The patients with umbilical cord prolapse during labor had higher rates of preterm deliveries, low-birth-weight infants, and non-vertex presentations than the control group did. Preterm delivery, non-vertex presentation, presence of polyhydramnios, and spontaneous membrane rupture increased the risk of umbilical cord prolapse significantly. In the regression analysis, gestational age and diagnosis to delivery interval greater than 10 minutes predicted adverse neonatal outcomes independently.
  
  
  CONCLUSIONS
  Umbilical cord prolapse is more common in cases of preterm delivery, non-vertex fetal presentation, and spontaneous rupture of membranes. A diagnosis to delivery interval greater than ten minutes is independently associated with an adverse neonatal outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey. c_iskender@yahoo.com.
authors.forename: O
authors.initials: O
authors.lastname: Kaymak
authors.forename: C
authors.initials: C
authors.lastname: Iskender
authors.forename: M
authors.initials: M
authors.lastname: Ibanoglu
authors.forename: S
authors.initials: S
authors.lastname: Cavkaytar
authors.forename: D
authors.initials: D
authors.lastname: Uygur
authors.forename: N
authors.initials: N
authors.lastname: Danisman
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects; D008297:Male; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000453:epidemiology*; D010298:Parity; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000175:diagnosis / Q000453:epidemiology; D011391:Prolapse; D012189:Retrospective Studies; D012307:Risk Factors; D014470:Umbilical Cord / Q000473:pathology*; D055815:Young Adult