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Related Concept Videos

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Teratogenicity

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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Neurulation is the embryological process which forms the precursors of the central nervous system and occurs after gastrulation has established the three primary cell layers of the embryo: ectoderm, mesoderm, and endoderm. In humans, the majority of this system is formed via primary neurulation, in which the central portion of the ectoderm—originally appearing as a flat sheet of cells—folds upwards and inwards, sealing off to form a hollow neural tube. As development proceeds, the...
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Sextuple Nuchal Cord Entanglement in a Preterm Neonate: A Case Report.

Rebecca Hicks1, Jesse Cottrell2

  • 1Marshall University Joan C. Edwards School of Medicine Huntington West Virginia USA.

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|May 1, 2026
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Summary

High-order nuchal cords (≥5 loops) are rare but can cause fetal distress. This case highlights the importance of antenatal detection and timely intervention for a positive outcome in extreme umbilical cord entanglement.

Keywords:
caesarean deliveryfetal surveillancemultiple loopsnon‐reassuring fetal heart tracingsnuchal cordumbilical cord entanglement

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Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Neonatal Care

Background:

  • Nuchal cord, umbilical cord around the fetal neck, is common.
  • Multiple loops (>4) are uncommon; high-order nuchal cords (≥5 loops) are rare.
  • High-order nuchal cords may lead to cord compression, fetal heart rate abnormalities, and intrauterine compromise.

Purpose of the Study:

  • To present a case of sextuple nuchal cord.
  • To discuss the potential risks and management of extreme nuchal cord entanglement.
  • To emphasize the importance of antenatal detection and vigilant fetal surveillance.

Main Methods:

  • Case report of a pregnant woman with a sextuple nuchal cord.
  • Antenatal diagnosis using color Doppler ultrasonography.
  • Fetal monitoring for non-reassuring fetal heart tracings.
  • Emergent preterm cesarean delivery.

Main Results:

  • Antenatal identification of a six-loop nuchal cord at 24 weeks.
  • Development of decreased fetal movement and non-reassuring fetal heart tracings.
  • Successful delivery of a live preterm neonate via cesarean section.
  • Neonate required NICU admission.

Conclusions:

  • Extreme nuchal cord entanglement poses significant perinatal risks.
  • Antenatal detection via color Doppler ultrasound is crucial.
  • Vigilant fetal surveillance and timely intervention are essential for optimizing outcomes in high-order nuchal cord cases.