Nuchal Cord and Perinatal Outcome

Abstract

Background and objectives It is often assumed that nuchal cord causes cord compression and thus low birth weight as well as intrapartum complications. The exact perinatal effect of presence of nuchal cord in a newborn is still under debate, The present study was taken up to establish the incidence of nuchal cord at delivery in the existing setup, intrapartum complications and the perinatal outcome that occurs in babies born with nuchal cord. Methodology This was a cross sectional study conducted at KLES Dr.Prabhakar Kore Hospital and Medical Research Centre, Belgaum, India, from January 2011 to March 2011.A sample size of 429 was calculated. Informed consent was obtained and eligible women were enrolled .The babies born with a cord around the neck were compared to those without. The particulars noted were age, BMI, parity, loops of cord around the neck (single or multiple), type of loop, mode of delivery, weight of the baby and Apgar score at birth and 5 minutes. The parameters were then compared and statistically analyzed using chi square test. Results Incidence of nuchal cord at the time of delivery was 13.75% , of which single nuchal cord was highest (76.66%). The study revealed that age, BMI (in kg/m 2 ), parity, gestational age and birth weight were not statistically significant to the presence of nuchal cord. Though instrumental deliveries were more in babies with nuchal cord it was not statistically significant (p= 0.932).Meconium VIII staining of liquor and fetal heart rate irregularities were significant findings in babies with nuchal cord(p<0.05). Apgar score < 7 at 1 minute was significantly low in nuchal cord group and Apgar score at 5 minutes and admission to neonatal unit was equivalent to those babies born without nuchal cord (p=0.947). Conclusion and interpretation Intrapartum events such as meconium staining of liquor and fetal heart rate irregularities were commonly associated with nuchal cord but this did not affect the mode of delivery and perinatal outcome.