Significance of cord problems at birth

Cord problems at birth were prospectively studied in 12,000 singleton deliveries, of which 258 (2.15%) babies had cord abnormalities. Nearly 32% of these cases had fetal distress and 20.5% had 1 minute Apgar score less than 6. Of the various cord problems nuchal cord was noted in 79.1%, cord prolapse in 12.4% and true knots in 3.9% cases. Perinatal mortality rate with cord problems was 85.27/1000 births. Neonatal problems noted were septicemia (4.56%), aspiration syndromes (13.48%), hypoxic ischemic encephalopathy (7.30%), neonatal convulsions (2.14%) and hyperbilirubinemia (2.14%). Although mean Hb and PCV were lower in those with cord round the neck as compared to normal controls, this difference was not significant. Seven babies had Hb less than 13 g/dl with nuchal cords. Neonates born with cord around the neck or with other cord abnormalities should be carefully followed up for morbidity.