Nuchal cord in post-term pregnancy – relationship to suspected intrapartum fetal distress indicating operative intervention

Abstract

Color Doppler Ultrasound was performed on 202 post-term pregnancies to detect the presence of a nuchal cord. A nuchal cord was diagnosed if the umbilical cord could be followed 360 degrees around the fetal neck. The results were not disclosed to the managing obstetrician, midwife, and patient. The perinatal outcome was analyzed according to Apgar score, umbilical cord artery and vein pH and base excess (BE), perinatal death, cesarean section, operative delivery for fetal distress (ODFD) and admission to neonatal intensive care unit (NICU). A nuchal cord was detected in 69 patients (34.2%). The incidence was not affected by parity or reduced amniotic fluid volume. There was no statistically significant increased risk for 1- and 5-min Apgar scores <7, umbilical artery pH <7.1, umbilical vein pH <7.20, umbilical artery base excess <-11, umbilical vein base excess <-11, perinatal death, cesarean section, ODFD or admission to NICU. Nuchal cord in post-term pregnancies is not associated with an increased risk for signs of fetal distress and operative intervention during labor and delivery.