Nuchal Cord and Perinatal Outsome - A Case Control Study

<p><strong>Background and Objective:</strong> The nuchal cord means the umbilical cord when it becomes wrapped around the fetal neck by 360 degree. It has been observed that the ultrasound finding of the nuchal cord not only makes the patient more apprehensive but leads to low threshold of the Caesarean section by the managing obstetrician as well. The purpose of this study was to determine the perinatal outcome associated with the cord around the neck in females presenting a hospital setting.<br /><strong>Methods:</strong> This case control study was conducted at Dr. Sulaiman al Habib Hospital Riyadh, Saudi Arabia.The data was collected retrospectively with the help of the predesigned proforma for six months and once the selected number of patients with the nuchal cord was enrolled, the total number of the patients was calculated. To create a control group every 12th patient without the nuchal cord was enrolled. Once the control group was formed then the primary and secondary outcomes were compared in both the groups.<br /><strong>Results:</strong> It was found that there is significant increase in fetal heart rate abnormalities in the nuchal cord group without increasing the rate of Caesarean section. However, the mean Appearance, Pulse, Grimace, Activity, and Respiration (apgar) score of the neonate in both the groups is not affected. The rate of admission to neonatal intensive care unit (NICU) also did not increase in our study group.<br /><strong>Conclusion:</strong> The nuchal cord though found to be associated with fetal heart rate abnormalities but does not increase the rate of Caesarean section. Hence all patients who have nuchal cord should be given trial of labor with continuous cardiotochographic (CTG) monitoring. It is also observed that the apgar score and NICU admission is not affected by the nuchal cord.</p>