INCIDENCE AND RISK FACTORS FOR UMBILICAL CORD PROLAPSE WHEN AMNIOTOMY IS
USED: A SWEDISH NATIONWIDE REGISTER STUDY
Abstract
Objective: This study aimed to examine incidence for umbilical
cord prolapse, and to explore risk factors in labours where amniotomy is
used. Design: Retrospective nationwide register study.
Setting: Delivery wards in Sweden included in the Swedish
Pregnancy Register. Participants: All births from January 2014
to June 2020, eligible participants n = 607 123. Methods: The
main outcome, umbilical cord prolapse, was identified in the data by the
International Classification of Diseases (ICD-10), diagnosis code O69.0.
Multiple binary logistic regression analysis was used to identify risk
factors. Results: Amniotomy was performed in 230 699 (38.0%)
of the births, in which umbilical cord prolapses occurred in 293 cases
(0.13%). Spontaneous rupture of the membranes occurred in 376 424
(62.0%), in which there were 458 cases (0.12%) of umbilical cord
prolapse. Risk factors associated with umbilical cord prolapse in labors
where amniotomy was used were higher parity, previous cesarean section,
presence of polyhydramnios, induction of labour and non-cephalic
presentation, that all increased the odds for umbilical cord prolapse.
Conclusions: The severe complication of umbilical cord prolapse
is rare in Sweden. Identified risk factors in labours where amniotomy is
used were higher parity, previous cesarean section, polyhydramnios,
induced labour and a baby in a non-cephalic presentation.
Funding: Linnaeus University and LÖF; the Swedish patient
insurance. The funders had no role in study design, analysis and
interpretation of the data, or writing the article.