European Journal of Molecular & Clinical Medicine

Abstract

Background: Despite that the description of nuchal cord was recorded 400 years B.C, the study of clinical implications of this prevalent condition has increased only in the past few decades. A nuchal cord occurs when the umbilical cord becomes wrapped around the foetal neck 360°. The diagnosis of a nuchal cord is made, when there is a suspicion due to the presence of variable decelerations in the fetal heart rate on the cardiotocograph (CTG) during labour. The present study is undertaken to know the prenatal diagnosis of nuchal cord and its effects on the labour and neonate.
Aims and Objectives: To Evaluate the role of ultrasound detection of nuchal cord in correlation with labour and neonatal outcome.
Material and Methods: It is a prospective comparative study done in Department of Radiodiagnosis Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chengalpet,TamilNadu, India. Total of 200 women after 36 weeks of gestation were included and studied variation in the type of delivery and neonatal factors by calculating relative risk.
Results and Observations: In our study Nuchal cord was present in 37 (18.5%) babies after delivery. The sensitivity of ultrasound detection of nuchal cord prior to delivery is 37.8% and the specificity is 79.8%. The risk of caesarean section is high in women who had given birth to babies with nuchal cord, but difference is not significant. Nuchal cord at birth has no effect on APGAR scores of the babies at 1 minute or 5 minutes, abnormal cardiotocography, admission into neonatal intensive care unit and arterial cord pH less than 7.2.
Conclusions: Our study concludes prenatal diagnosis of nuchal cord through ultrasound after 36 weeks of gestation is of limited use as the sensitivity is low. The presence of nuchal cord at birth does not appear to increase the risk of caesarean section or of poor neonatal outcome.