Effects of nuchal cord on fetomaternal outcome: an obstetrician challenge

Abstract

Objective: The objectives of the this study were to compare need of medical and surgical interventions and progress of labor, and feto-maternal outcome in patients with cord round neck versus without cord round neck at onset of labor or at term gestation. Methodology: This study was performed at NIMS Medical College Jaipur from January 2015 to January 2017. Total 200 cases were enrolled for a study, over a 2 year period. Among 200 patients, 100 control without cord round neck and 100 had cord round neck. Results: Among control groups 91% women delivered vaginally. Cesarean section was done in only 24% cases and 75% cases had delivered vaginally. Instrumental delivery in1%. Neonatal variables & obstetrical outcome were compared in tight nuchal cord groups and loose cord. In our Control group Majority of patients 75% were delivered vaginally. Loose nuchal cord does not associated with any adverse maternal & perinatal outcome. Tight cord round the neck associated with increased NICU admission with increased risk of low Apgar score. Evidence of fetal distress seen in 16% cases and outcome was poor in 3% cases. Conclusion: This is reasonably concluded from this study that cord round fetal neck remains a subject of anxiety for the paediatrician and for obstetrician & for the patient herself. Although with efficient mechanical supervision and by clinical observation adverse circumstances which effecting the fetus will be averted in time although they do occur.