Effect of Nuchal Cord on Mode of Delivery and Perinatal Outcome
Iraqi Postgraduate Medical Journal,
2018, Volume 17, Issue 2, Pages 137-144
Nuchal cord is blamed for problems that are encountered during delivery and for increased risk of adverse perinatal outcome such as fetal heart decelerations and perinatal mortality.
A case-control, prospective study.
To compare mode of delivery, duration of labour, and fetal outcome in pregnants with and without nuchal cord.
MATERIALS AND METHODS:
One hundred and fifty full term pregnant women were enrolled in this study, half of them were with nuchal cord (diagnosed by ultrasound and confirmed during labour) served as study group, and the remaining were without nuchal cord and served as control.
Fetomaternal outcome including mode of delivery, duration of labour, presence of intrapartum fetal heart rate irregularities, presence of meconium, fetal weight, Apgar score at 1 and 5 minutes, and neonatal care unit admission were compared in the two groups and the data were arranged on questionnaire forms and subjected to analysis.
Pregnancy with Nuchal cord has 2.6 folds increase in caesarean section rate than controls (21.3%) vs. (9.3%), mainly because increased fetal heart rate irregularities (3.2 folds), and prolonged second stage of labour.
Meconium staining of liquor was more frequently seen among nuchal cord group than controls. Fetal outcome was found to be associated with higher incidence of low birth weight, low Apgar score at 1 and 5 minutes and more neonatal care unit admission in pregnants with nuchal cord.
CONCLUSION: Nuchal cord is associated with adverse perinatal outcome including low apgar scores, fetal distress and increased cesarean section rate.
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