[Study of umbilical cord coiling and variable deceleration]

Using cardiotocogram and umbilical arterial gas analysis, the presence or absence and variations of umbilical cord coiling were examined with relation to the incidence of variable deceleration (V.D.) and neonatal asphyxia. The results obtained were as follows. 1) The incidence of V.D. with cord coiling was higher than that without cord coiling (p less than 0.005). The incidence of severe V.D. with cord coiling was also higher than that without cord coiling (p less than 0.005). 2) The mean Apgar scores of cases with cord coiling were lower than that without cord coiling (p less than 0.02). 3) On the umbilical arterial gas analysis, the mean pH of cases with cord coiling was lower than that without cord coiling (p less than 0.05). And the mean pCO2 of cases with cord coiling was higher than that without cord coiling (p less than 0.005). So neonate with cord coiling showed a tendency towards respiratory acidosis in comparison with that without cord coiling. 4) The incidence of neonatal asphyxia with cord coiling was 16.0% (Apgar score less than or equal to 7), 20.0% (pH less than 7.20) and that without cord coiling was 8.8%, 13.2%, respectively. Although there was no statistically significant difference, a tendency was observed towards a higher rate of neonatal asphyxia with cord coiling. 5) The incidence of neonatal asphyxia with severe V.D. was 44.4% (Apgar score less than or equal to 7), 36.1% (pH less than 7.20) and that without severe V.D. was 5.7%, 8.6%, respectively. There was a statistically significant difference (p less than 0.005, p less than 0.005). In addition, the incidence of neonatal asphyxia with repeated V.D. was 35.3% (Apgar score less than or equal to 7), 44.1% (pH less than 7.20) and without repeated V.D. was 3.8%, 6.5%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)