PREVALENCE OF RISK FACTORS OF UMBILICAL CORD PROLAPSE IN LABORING WOMEN: A MULTICENTER CROSS-SECTIONAL STUDY.

JPUMHS; 2025:15:01,203-211. http://doi.org/10.46536/jpumhs/2025/15.01.614

Abstract

BACKGROUND: Umbilical cord prolapse (UCP), a rare but life-threatening obstetric
emergency, is linked to increased perinatal mortality and morbidity. Although previous studies
have established risk factors, multicenter data concerning their prevalence and effect are scarce.
AIMS: The aims of this study were to establish the prevalence of maternal, fetal, and obstetric
risk factors for UCP and also to assess their correlation with maternal and neonatal outcomes.
METHODS: Multicenter cross-sectional study in eight tertiary hospitals over five years. UCP-
confirmed laboring women (n=150) were compared with matched controls with no UCP
(n=300). Demographic data, fetal presentation, obstetric interventions (such as amniotomy),
and outcomes (APGAR score, NICU admission, delivery mode) were compared using chi-
square tests and multivariate logistic regression. RESULTS: Non-cephalic fetal presentation
(OR=6.2, 95% CI: 3.8–9.9), multiparity (OR=2.4, 95% CI: 1.5–3.8), polyhydramnios (OR=4.1,
95% CI: 2.3–7.4), and amniotomy (OR=3.0, 95% CI: 1.7–5.2) were risk factors for UCP.
Neonates within the UCP group had lower 5-minute APGAR scores (7 vs. 9, p<0.001) and
higher NICU admission rates (32% vs. 8%, p<0.001). Cesarean delivery was more common in
UCP cases (88% vs. 25%, p<0.001). CONCLUSION: Multiparity, amniotomy,
polyhydramnios, and non-cephalic presentation are significant non-modifiable and modifiable
risk factors for UCP. These results highlight the importance of strict intrapartum surveillance
of high-risk pregnancies and aware decision-making during obstetric procedures.