Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Umbilical cord abnormalities may be associated with fetal heart rate irregularities this might
change the mode of delivery from vaginal delivery to cesarean delivery and may be responsible for
adverse perinatal outcomes.
OBJECTIVE:
To verify the association between umbilical cord abnormalities and fetal heart irregularities that
lead to urgent cesarean delivery.
MATERIALS AND METHODS:
One hundred and six full term singleton pregnant women were enrolled in this study, 51 of them
developed non reassuring fetal heart rate (Abnormal CTG) and emergency cesarean delivery was
done for them, those represent the study group, the other 55 women had reassuring CTG and
delivered vaginally, those represent control group. Umbilical cord and the neonate were examined
after delivery for abnormality. The data obtained were fixed on questionnaire papers and then
subjected to analysis.
RESULTS:
Umbilical cord abnormalities were present in higher significant rate (43.1%) in emergency
cesarean delivery group than vaginal delivery group. Although single umbilical cord abnormalities
was present more than multiple umbilical cord abnormalities but the latter associated significantly
with increase rate of cesarean delivery (P value is 0.05). Nuchal cord was present in (31.3%) of
women of study group and in (16.4%) of control group. The most fetal heart abnormality found
was fetal deceleration (96.1%) and most commonly was late deceleration (42.8%).
Newborns with multiple umbilical cord abnormalities had significantly lower weight and lower
Apgar scores than those with single cord abnormalities, P value 0.018, 0.037 respectively.
CONCLUSION:
Umbilical cord abnormalities are associated with increase rate of cesarean delivery because of fetal
heart rate irregularities. The most common abnormality is umbilical cord entanglement around the
fetal neck.
Multiple umbilical cord entanglement are responsible significantly for increased cesarean rate and
adverse perinatal outcomes.