Nuchal cord and perinatal outcome

to find out the incidence of nuchal cord at delivery, intrapartum complication and perinatal outcomes in the cases with nuchal cord.

A prospective, cross-sectional, comparative study done at Kathmandu Medical College Teaching Hospital (KMCTH) between March 2006 to September 2006. Total 512 deliveries occurred during this period that were enrolled in the study and were analyzed for presence of nuchal cord at the time of delivery, number of coils whether loose or tight, intrapartum complications and perinatal outcome. The cases with nuchal cord at the time of delivery were taken as study group and the cases without nuchal cord served as control group. Outcome variables between the two groups were compared. Outcome variables used were meconium staining of liquor, rate of instrumental and caesarean delivery, intrapartum fetal heart rate (FHR) irregularities. As a measure of perinatal outcome Apgar score<7 at 1 minute and 5 minutes and incidence of neonatal unit admission was taken.

Incidence of nuchal cord at the time of delivery was 22.85%. Incidence of single nuchal cord was highest (18.95%). Intrapartum complications like FHR irregularities and meconium staining of liquor were increased in nuchal cord group but statistically not significant. Instrumental delivery rate was high in nuchal cord group but statistically not significant (0.108). However, caesarean section rate was high in the group without nuchal cord (p=0.029). Apgar score<7 at 1 minute was significantly low in nuchal cord group (p=0.010) but apgar score at 5 minutes and admission to neonatal unit was not more common.

Nuchal cord is not associated with adverse perinatal outcome.