Nuchal Cord and Perinatal Outcome Prospective Observational Study

Abstract

Nuchal cord or umbilical cord entanglement, is defined as 360° turn of umbilical cord around the fetal neck. Approximately, 16–30% of all pregnancies are complicated with nuchal cord. The incidence of multiple nuchal cord is reported as 2.5–8.3%, as well. With the developing pregnancy, the frequency of NC increases from 5.8% at 20th gestational week up to 29% at 42nd gestational week. The presence of umbilical cord entanglement has been a big controversy in perinatal medicine for decades, and actually for centuries. It is mentioned as silent risk of pregnancy after the eighth month, in historical medical books from seventeenth and eighteenth century. There are several studies, revealed adverse perinatal outcomes related with NC. But also, there exist so many studies which are not able to show this relationship (see below). The presence of nuchal cord is not a unique condition. Variable tightness of nuchal cord, multiple nuchal cord loops and the dynamic interplay between the cord loop, moving fetal parts and fetal tone during various stages of labor may be contributors of the controversy on the clinical significance of NC. In this study, hundred primigravids were recruited with nuchal cord diagnosed by Doppler ultrasonography; whereas the rest of the study population was included in the “Control group”. Both groups were followed up during labor.