Total 100 patients were selected; 50 pregnant women with nuchal cord diagnosed by ultrasound Doppler at 35 to 40 weeks of gestation and confirmed at delivery were assigned as cases (3 false positive cases with presence of nuchal cord on antenatal USG, but absent at delivery were excluded) and 50 pregnant women without nuchal cord were assigned as controls.
Their labour events like foetal heart rate irregularities, mode of delivery, presence of nuchal cord and its number of loops, cord length from its insertion on placenta up to the umbilicus, whether loose or tight, birth weight, APGAR score at 1 minute and 5 minutes and admission to neonatal unit, need for intervention, days of stay in NICU, neonatal death were noted.
We observed that no neonates were found to have Apgar score <7 at 5 minutes in both nuchal cord and non-nuchal group.
Total 13 neonates admitted in NICU; 8 (16%) from nuchal cord group (4 neonates for perinatal asphyxia, 2 neonates for transient tachypnoea of newborn and 2 neonates for low birth weight), and 5(10%) from non-nuchal cord group (3 neonates for perinatal asphyxia, 1 neonate for transient tachypnoea of newborn and 1 neonate for VSD).
Does the nuchal cord really affect the outcome of delivery?
The maternal delivery record provided the data for gestational age, method of delivery, presence of meconium in the amniotic fluid, fetal heart rate monitoring that was done routinely, presence of nuchal cord, number of cords, instrumental delivery and any other complications that may have occurred at the time of delivery.
Elective section cause an additional morbidity and does not justify in case of nuchal cord as outcome is almost same in both condition.
There was no indication that the presence of a nuchal cord influences the length of the pregnancy, a finding that agrees with other reports 10-13.
in term and post term deliveries - do we need to know?
The total number of nuchal cord loops recorded in partograms was 488 (27%), of which 83% were simple loops, 13.
The ages of patients with nuchal cord loops ranged from 17 to 44 years; 88% were between 21 and 34 years old, and 78% were primiparas or secundiparas.
To our knowledge, this is the first study which has tried to find a correlation between method of delivery and obstetric results in cases with only nuchal cord association.
Vaginal deliveries occurred significantly more often in the nuchal cord group (P <.
The control group had more breech presentations and placental abruptions than the nuchal cord group; however, the difference was not statistically significant.
The percentage of infants born with an initial Apgar score of less than 7 in the nuchal cord group was almost twice that of infants in the control group (8.