Prognosis of delivery from below with umbilical cord circular: 456 case reports at the gynecology and obstetrics department of the teaching hospital of cocody

Objective: The objective of our study was to analyze fetal prognosis during delivery from below in the presence of a cord circular in a country with bad medical care. Methodology: This was a cross-sectional study with descriptive and analytical aims relating to delivery from below with an umbilical cord circular. The study covered a period of 3 years from January 2016 to December 2018 and took place at the Teaching Hospital of Cocody. Results: the frequency of deliveries from below with a circular cord was 3.3%. The average age of the population was 28 with extremes of 17 and 42 patients were evacuated in 69.3% of the cases and, the presence of the cord circular was specified in 41.7% of the cases. Our patients were nulliparous in 39.9% of the cases. Among them, 63.8% had performed at least 4 ANCs. In 57.7% of cases (263/456), an emergency caesarean section had been decided before delivery. At birth, the umbilical cords were short (<50cm) in 2.6% of the cases, normal (50 to 70 cm) in 94.8% of the cases and long (> 90cm) in 2.6% of the cases. 19 neonatal deaths were observed (4.2% of cases). Neither fetal weight nor hours of labor were found as determinants of stillbirth in this association. Conclusion: Delivery from below is possible when the umbilical cord circular is unique, as long as there is rigorous monitoring of the labor of delivery and that emergency caesareans section once decided, are performed within a reasonable time.