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Modifiable and non-modifiable risk factors for umbilical cord prolapse when amniotomy is used: a swedish nationwide register study
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-8561-4890
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.ORCID iD: 0000-0002-0961-5250
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-0895-674x
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-1944-773X
2023 (English)In: Presented at the 33rd ICM Triennial Congress, Bali, Indonesia, June 11-14, 2023, 2023Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background

Amniotomy is one of the most commonly used interventions in modern obstetric and midwifery practice. The most severe complication to amniotomy is umbilical cord prolapse; a rare obstetric emergency that can cause fetal morbidity and/or mortality. 

Objectives

To identify risk factors for umbilical cord prolapse in labours when amniotomy is performed.

Methods

This retrospective nationwide study included data from the Swedish Pregnancy Register on all births from January 2014 to June 2020. 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

During the study period, a total of 614 857 women gave birth, of which 234 756 (38.18%) underwent amniotomy. Umbilical cord prolapse occurred in in 362 (0.15%) of the cases. In the final multiple regression model, twin delivery was the strongest non-modifiable risk factor (OR 10.90). Other risk factors associated with umbilical cord prolapse were higher maternal age (OR 1.02), higher Body Mass Index (OR 1.02), increasing parity (OR 1.06) and maternal country of birth outside of the EU (OR 1.43). Induction of labour was the strongest modifiable risk factor (OR 2.82). Epidural analgesia decreased the probability for umbilical cord prolapse (OR 0.33).

Conclusions

Risk factors for umbilical cord prolapse when amniotomy is used were maternal country of birth outside of the EU, higher maternal age and BMI, increasing parity, induction of labour and twin delivery. 

Key message

Knowledge on risk factors to umbilical cord prolapse, when using amniotomy, can prevent causing significant harm. In the present study; induction of labour was a modifiable risk factor for umbilical cord prolapse.

Place, publisher, year, edition, pages
2023.
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:lnu:diva-123451OAI: oai:DiVA.org:lnu-123451DiVA, id: diva2:1786103
Conference
33rd ICM Triennial Congress, Bali, Indonesia, June 11-14, 2023
Available from: 2023-08-07 Created: 2023-08-07 Last updated: 2025-02-06Bibliographically approved

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Tallhage, SofiaÅrestedt, KristoferSchildmeijer, KristinaOscarsson, Marie

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