DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183750

Epidemiological, clinical and therapeutic profile of the umbilical cord prolapse at the Befelatanana University Hospital Centre of Obstetric Gynecology in Antananarivo, Madagascar

Randriamahavonjy R., Rakotonirina Andriamaro M., Ratsiatosika Andriamanetsiarivo T., Housni I., Abasse B. A., Rakototiana A F., Andrianampanalinarivo H. R.

Abstract


Background: Umbilical cord prolapse is a major obstetrical emergency that threatens the fetal prognosis during labor. The objective of this study was to describe the epidemiologic and clinical profile of pulsatile cord prolapse at the Befelatanana University Hospital of Obstetric Gynecology.

Methods: It is about a retrospective cross-sectional study conducted at the Befelatanana University Hospital of Obstetrics and Gynecology in Antananarivo over a period of 3 years, from January 1st, 2012 to December 31st, 2014. We have identified all cases of umbilical cord prolapse. We studied obstetric, neonatal and maternal parameters.

Results: We found 70 cases of pulsatile umbilical cord prolapse, a prevalence of 0.28% of deliveries. The average age of the patients was 28 ± 3.2 years with extremes ranging from 18 to 43 years. Multiparous women predominated with (51.43%) Pregnancy was long term, with 71.43% of cases associated with placenta praevia, lateral prolapse of the limb, long cord and contracted pelvis. The prolapse of the cord was 1st degree with 44.29% of cases. All patients had received (100%) of oxygen therapy. Almost all patients were caesarized (95.71%). Neonatal complications were represented by admission to neonatal intensive care unit (32.86%), perinatal asphyxia (31.43%), prematurity (28.57%), neonatal infection (4.29%) and neonatal death (10%).

Conclusions: The umbilical cord prolapse is relatively rare. Fetal extraction in the shortest possible time, especially when the cord is externalized, which is the main determining factor of neonatal prognosis.


Keywords


Madagascar, Obstetrical emergency, Prevalence, Umbilical cord prolapse

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References


Traore Y, Dicko TF, Teguete B, Mulbah JK, Adjobi R, Nguessan E, Tegnan A. Cord Prolitis: Aetiological Factors and Fetal Prognosis for 47 Collected Cases in a Reference Health Center. Mali Medical. 2006

Boyle JJ, Katz VL. Umbilical cord prolapse in current obstetric practice J Reprod Med. 2005;50:303-6.

National Institute of Statistics (Instat) and ICF Macro. Demographic and Health Survey of Madagascar 2008-2009. Antananarivo, Madagascar: Instat et ICF Macro..

Rakotozanany B, Randriambololona DMA, Razafimadimby F, Rakotomalala NZ, Randriambelomanana JA, Andrianampanalinarivo HR. Neonatal prognosis of the procidence of the pulsatile umbilical cord at Befelatanana hospital Madagascar. Med Tropic Health. 2015;25:434-5.

Gannard P, Ramanah R, Cossa S, Mulin B, Maillet R, Riethmuller D. Cord Prolitis: About a 23-year series of activities. J Gynecol Obstet biol Reproduc. 2012;41:574-83.

Prabulos AM, Philipson EH. Prolapse of the umbilical cord. Is the delay between diagnosis and delivery critical? J Reprod Med. 1998;43:129-32.

Tan WC, Tan LK, Tan HK, Tan AS. Audit of emergency "caesarean" caesarean sections due to cord prolapse in terms of response time and perinatal outcome. Ann Acad Med Singapore. 2003;32:638-41.

Dufour P, Vinatier D, Bennani S, Tordjeman N. Cord Procidence: Literature Review of 50 Observations. J Gynecol Biol Reprod. 1996;25:841-5.

Jamain B. Obstetrical practice. Paris: Masso; 2009:5, 27, 64, 89,93.

Kola S. Umbilical Cord Procidence: Factor, Aetiology and Fetal Prognosis. About 60 cases identified at Bamako District Teaching Hospital (MALI). Bamako;2006-M 325.

Driscoll J A, Sadan O, Van Gelderen J, Holloway G A.Cord prolapse. Can we save more babies J Case reports? Br J Obstét Gynécol. 2007;481:29.

Prabulos AM, Philipson EH.Umbilical cord prolapsed. Is the time from diagnosis to delivery critical? J Reprod Med. 2008;2:129-32.

Randrianatoanina F, Rakotosalama D, Ravelosoa E, Rakotondramanana N. Interests of bladder filling during pulsatile umbilical cord procidence on the 14 cases observed at CHUA Befelatanana maternity ward. Med trop 2007;68:58-60.

Bouayad S. The procidence of the umbilical cord about the 97 cases. University of Sidi Mohammed Ben Abdellah. Morocco;2011:103/11.

Dao B. Umbilical Cord Procidence: Risk Factor and Prognosis in African Settings. Med Black Afr. 2002;7:351-4.

Guikovati JP, Dellenbach P, Lewin D. The procidence of the cord and limbs. In: Vokaer. Treaty of obstetrics. Paris: Masson, 1985, 473-476.

Alouini S, Mesnard L, Megier P, Lemaire B, Coly S, Desroches A. Cord Procidence: Obstetrical Management and Neonatal Consequences. J Gynecol Obstet Biol Reproduct. 2010;39:471-7.

Rozilla S, Khan, Tahira N. Umbilical cord prolapsed. A review of diagnosis to delivery interval on perinatal and maternal outcome. Department of obstetrics and Gynaecology, Aga Khan University Hospital, Pakistan;2007:2-4.

Berlan M, Magnin G. Premature rupture of membranes. EMC Obstetrics. 2004;4(4):3.