FETAL OUTCOME;

Abstract

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.