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Nuchal cords and neonatal outcome
G D Hankins1, R R Snyder, J C Hauth
1Department of Obstetrics and Gynecology, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas.
Obstetrics and Gynecology
|November 1, 1987
Summary
Nuchal cords (cords around the neck) are linked to more fetal heart rate (FHR) changes during labor and a higher incidence of umbilical artery acidemia in newborns. This indicates potential risks associated with nuchal cords.
Area of Science:
- Obstetrics
- Neonatal Health
- Fetal Monitoring
Background:
- Nuchal cords, or umbilical cords wrapped around a fetus's neck, are a common intrapartum finding.
- The clinical significance and impact of nuchal cords on neonatal outcomes require further elucidation.
Purpose of the Study:
- To investigate the association between nuchal cords and specific neonatal complications at term gestation.
- To evaluate the relationship between nuchal cords and fetal heart rate (FHR) patterns and umbilical artery acidemia.
Main Methods:
- A case-control study comparing 110 term infants with nuchal cords to 110 control infants.
- Analysis of fetal heart rate (FHR) decelerations during the first and second stages of labor.
- Assessment of umbilical artery acidemia in newborns.
Main Results:
- Newborns with nuchal cords exhibited a significantly increased prevalence of umbilical artery acidemia (P < .05).
- Variable FHR decelerations were more frequent in both the first (P < .0001) and second (P < .0001) stages of labor for infants with nuchal cords.
- Umbilical artery acidemia in affected newborns was predominantly mixed or respiratory in origin.
Conclusions:
- Nuchal cords are significantly associated with an increased incidence of variable FHR decelerations during labor.
- The presence of a nuchal cord is linked to a higher prevalence of umbilical artery acidemia in term newborns.
- These findings underscore the importance of monitoring infants with nuchal cords for potential adverse outcomes.