A study of fetomaternal outcome in singleton pregnancies with cord around neck

Authors

  • Ankita Gahlot Department of Obstetrics and Gynecology, SMS Medical College Jaipur, Rajasthan, India
  • Jyotsna Vyas Department of Obstetrics and Gynecology, SMS Medical College Jaipur, Rajasthan, India
  • Sunita Himani Department of Obstetrics and Gynecology, SMS Medical College Jaipur, Rajasthan, India
  • Ekta . Department of Obstetrics and Gynecology, SMS Medical College Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20212657

Keywords:

Nuchal, Oligohydramnios, Preelampsia, Preterm

Abstract

Background: Entanglement of umbilical cord around the foetal neck is a common finding at ultrasonography. A nuchal cord occurs when the umbilical cord becomes wrapped around the foetal neck by 360°. Nuchal cord is very common, with the prevalence rates of 6-37%. Up to half of nuchal cords resolve before delivery.

Methods: This study was conducted on 100 women irrespective of parity with healthy singleton term pregnancies with cephalic presentation in the department of obstetrics and gynaecology, SMS Medical College Jaipur. They were included in study after applying inclusion criteria and a written informed consent was taken. Strict fetomaternal monitoring was done during labour and data was interpreted in terms of percentage.

Results: Out of 100 cases 71% delivered vaginally, 29% underwent caesarean section. None of the caesarean was done for cord around neck as the only indication. The indications for caesarean section were previous caesarean (34.4%), preeclampsia (13.7%), severe oligohydramnios (31%) and non-reassuring foetal heart rate (20%). Among the women who delivered normally, 53% had single loop, 29.5% had two loops, 14% had three loops and 2% had more than 3 loops. Among women who underwent caesarean section, 65% had single loop, 31% had two loops and 14% had more than two loops. Regarding neonatal outcome 9% neonates were admitted in NICU for reasons like meconium aspiration (33.3%), preterm (44%) and preeclampsia (22%).

Conclusions: Cord around neck per se is not an indication for caesarean section and these cases can be delivered vaginally if careful intrapartum monitoring is done.

References

Moldenhauer JS. Abnormal Position and Presentation of the Fetus. Merck Manual. Available from: https://www.msdmanuals.com/en-in/home/women-s-health-issues/complications-of-labor-and-delivery/abnormal-position-and-presentation-of-the-fetus. accessed on 26 December 2017.

Peregrine E, O'brien P, Jauniaux E. Ultrasound detection of nuchal cord prior to labor induction and the risk of cesarean section. Ultrasound Obstet Gynecol. 2005;25(2):160-4.

Cruikshank DW, Scott JR. Breech, other malpresentations, and umbilical cord complications. In: Cruikshank DW, Scott JR, eds. Danforth’s Obstetrics and Gynecology. Philadelphia: Lippincott Williams and Wilkin; 2003:381-395.

Collins JH. Nuchal cord type A and type B. Am J Obstet Gynecol. 1997;177:94.

Rumack CM, Wilson SR, Charboneau JW, Levine D eds. Diagnostic Ultrasound, 4th ed. (two-volume set). Philadelphia, PA: Mosby; 2011:2192 pp.

Peesay M. Cord around the neck syndrome. BMC Pregnanc Childbirth. 2012;12(1):11-2.

Begum A, Sultana H, Hasan R, Ahmed M. A clinical study of fetal outcome in cases of nuchal cord. J Armed Forces Med Coll Bangladesh. 2011;7(1):25-7.

Joshi K, Saxena R, Bhat M, Lomrod Y, Verma K. Incidence of cord around the neck and its effects on labour and neonatal outcome. Adv Hum Biol. 2017;7:15-8.

Phadol VA, Naik AS, Naik SA. Nuchal cord and perinatal outcome in a rural hospital: a case control study. J Evol Med Dent Sci. 2016;5(53):3531-5.

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Published

2021-06-28

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Original Research Articles