Incidence of umbilical cord around the neck and its effects on mode of delivery and fetal outcome at tertiary care hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20205924Keywords:
Incidence of umbilical cord, Mode of delivery, Fetal outcomeAbstract
Background: Umbilical cord is one of the fetal membranes. It is developed from the yolk sac. Umbilical cord is tubular structure. Approximate length of the cord is 50 cm. Umbilical cord around the neck is called as the nuchal cord. The aim of the study is to find out the incidence of umbilical cord around the neck at the time of delivery and its fetal outcomes.
Methods: It is a retrospective observational study. This study was conducted in the department of obstetrics and gynecology at a tertiary care hospital over a period of 6 months (Feb-Jul 2020). Out of 542 patients, 388 were enrolled in this study after the inclusion and exclusion criteria, of which 101 were delivered with umbilical cord and the remaining were 287 patients in control group.
Results: Present study showed 38.4% incidence of umbilical cord at the time of delivery. Incidence is more among the primigravida and it is statistically significant. Both intrapartum and postpartum risks are not related to umbilical cord around the neck. Mean length of the cord in patients delivered with cord around the neck is more when compared to the control group and has significant p value.
Conclusions: This study concludes that the presence of umbilical cord, alone is not an indication for caesarean section. Umbilical cord with 3 loops was associated with increased operative delivery and low Apgar score, proper intrapartum surveillance and portogram leads to good fetal outcome.
References
Singer DB, Macpherson T. Fetal death and macerated stillborn fetus. In: Wigglesworth JS, Singer DB, editors. Textbook of Fetal and Perinatal Pathology. Boston: Blackwell Scientific Publication. 1991;1:266-7.
Fetus or Newborn Problems. Labor and Delivery Complications: Merck Manual Home Edition. 2010.
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.
Meyer WW, Rumpelt HJ, Yao AC, Lind J. Structure and closure mechanism of the human umbilical artery. Eur J Pediatr. 1978;128(4):247-59.
Fetal Circulation. Available from: www.heart.org. accessed on 22 December 2017.
Saleh, R; Reza, HM. Short review on human umbilical cord lining epithelial cells and their potential clinical applications. Stem cell res therapy. 2017;8(1).
Crawford JS. Cord around the neck a further analysis of medicine. Acta Pediatrics. 1964;53:535-7.
Collins JH, Collins CL, Weckworth SR, Angelis L. Nuchal cords; timing of perinatal diagnosis and duration. Am J Obstet Gynecol. 1995;173:768.
Dhar KK, Ray SN, Dhall GI. Significance of nuchal cord. J Indian Med Assoc. 1995;93(12):451-3.
Janet D, Larson MD, William F, Rayburn MD, Crosby RSS, Gary R et al. Multiple cord entanglement and intrrapartum complications. Am J Obstect Gynecol. 1995;173:1228-31.
Miser WF. Outcome of infants born with nuchal cords. Family practice service, Reynolds Army Community Hospital. Fortsill, UK. J Fam Pract. 1992;34(4): 441-5.
Bashir F, Huma Z, Aslam P. Cord around the neck and its Fetal outcomes. J Soc Obstet Gynaecol Pak. 2017;7(3):133-6.
Schaffer L, Burkhardt T, Zimmermann R, Kurmanavicious J. Nuchal cords in term and post term deliveries- Do we need to know? Obstet Gynecol. 2005;106:23-8.
Kasturi D, Marathe S, Manjunath N. A casecontrol study on perinatal outcome in neonates with cord around the neck in a tertiary care hospital, Hubli, Karnataka. Int J Reprod Contracept Obstet Gynecol. 2014;3(1):105-8.
Begum AA, Sultana H, Hasan R, Ahmed M. A Clinical Study of Fetal Outcome in Cases of Nuchal Cord. JAFMC Bangladesh. 2011;7(1);25-7.