316: The relationship of nuchal cord and true knot with intrauterine fetal demise (IUFD) in pregnancy > 24 weeks gestation

Abstract

DEMISE (IUFD) IN PREGNANCY > 24 WEEKS GESTATION KATHLEEN SMITH, JAMES EGAN, YU MING VICTOR FANG, LISA DRIES, MARY BETH JANICKI, CAROLYN ZELOP, University of Connecticut, Farmington, Connecticut, University of Connecticut, Obstetrics and Gynecology, Farmington, Connecticut, St Francis Hospital, Hartford, Connecticut, St. Francis Hospital, Hartford, Connecticut OBJECTIVE: To evaluate the relationships between nuchal cord and true knot, with IUFD, in deliveries at 24 weeks gestation and beyond. STUDY DESIGN: The perinatal database at our institution was queried for all deliveries at least 24 weeks gestation occurring between 02/02 and 07/07. Data regarding nuchal cord, true knot, fetal gender, gestational and chronic hypertension (HTN), diabetes mellitus (DM), fetal anomalies, Group B Streptococcus (GBS) carrier status, and IUFD were collected from the perinatal database. Logistic regression analysis was used to estimate adjusted odds ratios (AOR) and test significance of relationships. RESULTS: A total of 16,948 deliveries had data available for analysis. Of these, 53 (0.3%) were IUFD. The mean gestational age was 38.8 weeks. The mean birth weight was 3280 g. For patients with IUFD the mean gestational age was 33.9 weeks. The mean birth weight was 2060 g. CONCLUSION: Nuchal cord is not associated with a higher rate of IUFD after 24 weeks gestation. True knot is associated with IUFD. This association persists after accounting for other factors, including HTN and DM, known to be associated with increased risk of IUFD.