Incidence Of Cord Research Articles

FETO-MATERNAL OUTCOME OF ANTE-NATAL CARE PATIENTS WITH CORD AROUND THE NECK FINDING IN TERM PREGNANCY

Umbilical cord may sometimes surround the fetal neck, often detected during routine ultrasonography or delivery. The cord around neckmay untwines spontaneously, however, the continued presence of cord loops around neck affects the fetal outcome. Objectives: To study the incidence of cord around the neck finding (nuchal cord)and feto-maternal outcome. Methodology: The retrospective study was conducted at a tertiary care hospital of Central India. During the study period of 18 months, out of 1672deliveries, 470 deliveries had nuchal cord. The relevant data was extracted from the hospital records. Results: At the time of delivery, nuchal cord incidence was 28.1%. Out of 470 deliveries, 273 underwent LSCS with fetal distress possibly due to oligohydramnios as their prime indication. Low birth weight was seen among 26.8% newborns. 8.7 % newborns were admitted in NICU. However, no perinatal mortality was reported. Conclusion: Presence of nuchal cord at the time of delivery is quite common. One must rely on clinical skills for pre-delivery diagnosis of nuchal cord, especially in rural and peri-urban areas,where last-trimester USG reports are not available. The nuchal cord when accompanied by oligohydramniosdoes interfereduringlabour, and the outcome of delivery with respect to fetal distress.

Incidence of cord around the neck and its effects on labour and neonatal outcome

Background: The umbilical cord is a narrow tube-like structure that connects the developing baby to the placenta. Most of the nuchal cords diagnosed in early pregnancy get spontaneously uncoiled. This study was carried out to show that such natural occurrence does not have significant effect on pregnancy, labour and neonates if proper intra-partum foetal heart rate (FHR) monitoring could be provided by a caregiver. Materials and Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sardar Patel Medical College, Bikaner (Rajasthan). For completing 100 cases with nuchal cord, we had to observe 506 cases and by which we took out the incidence of nuchal cord and which was separately categorised into single, double, triple and four and more than four groups. Results: The present study showed mean cord length also increases with number of loops (50.93 cm in single loop as compared to 72.33 cm) in cases with four loops and showed that patients having tight nuchal cord have higher incidence of caesarean as well as forceps delivery, but these were not statistically significant (P = 0.56 and P= 0.57) and Apgar score <7 at 1 min, FHR deceleration and meconium staining of liquor were statistically higher significant (P = 0.001,P= 0.0001 and P= 0.001, respectively). Conclusion: At present, expertise to diagnose multiple and tight loops on ultrasound are limited, which should be the aim for future. Multicentric and large studies are further required in association with more specific and sensitive diagnostic aid for tight and multiple loops so as to provide the best perinatal management with good foetal outcome.