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CC BY-NC-ND 4.0 · AJP Rep 2018; 08(02): e89-e94
DOI: 10.1055/s-0038-1649486
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risk Factors for Umbilical Cord Prolapse at the Time of Artificial Rupture of Membranes

Tetsuya Kawakita
1   Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Chun-Chih Huang
2   Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland
3   Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, District of Columbia
,
Helain J. Landy
4   Department of Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, District of Columbia
› Author Affiliations Funding The data included in this article were obtained from the Consortium on Safe Labor, supported by the Intramural Research Program of the NICHD, NIH, through contract number HHSN267200603425C.
This project was funded in part with Federal funds (Grant # UL1TR000101 previously UL1RR031975) from the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through the Clinical and Translational Science Awards Program (CTSA), a trademark of DHHS, part of the Roadmap Initiative, “Re-Engineering the Clinical Research Enterprise.”
Further Information

Publication History

03 February 2018

22 March 2018

Publication Date:
10 May 2018 (online)

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Abstract

Objective The aim of the study was to examine the association between cervical exam at the time of artificial rupture of membranes (AROM) and cord prolapse.

Study Design We conducted a retrospective cohort study using the data from the Consortium on Safe Labor. We included women with cephalic presentation and singleton pregnancies at ≥ 23 weeks' gestation who underwent AROM during the course of labor. Multivariable logistic regression was used to calculate the adjusted odds ratio (aOR) with 95% confidence interval (95% CI), controlling for prespecified covariates.

Results Of 57,204 women who underwent AROM, cord prolapse occurred in 113 (0.2%). Compared with dilation 6 to 10 cm + station ≥ 0 at the time of AROM, <6 cm + any station and 6–10 cm + station ≤ −3 were associated with increased risks of cord prolapse (<6 cm + station ≤ −3 [aOR, 2.29; 95% CI, 1.02–5.40]; <6 cm + station −2.5 to −0.5 [aOR, 2.34; 95% CI, 1.23–4.97]; <6 cm + station ≥ 0 [aOR, 3.31; 95% CI, 1.39–8.09]; and 6–10 cm + station ≤ −3 [aOR, 5.47; 95% CI, 1.35–17.48]).

Conclusion Cervical dilation < 6 cm with any station and 6 to 10 cm with station ≤ −3 were associated with a higher risk of cord prolapse.

Keywords

artificial rupture of membranes - cervical dilation - cord prolapse - fetal station - risk factors

Paper Presentation Information

This article was presented as a poster presentation (#340) at the SMFM 38th Annual Meeting: The Pregnancy Meeting, Dallas, TX (January 29–February 3, 2017).


 

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