Introduction: Abnormal cord parameters associate with high rate of asphyxia during delivery, foetal anomalies, non-reassuring foetal status, respiratory distress, foetal growth restriction and delivery interventions.Objective: To study the correlation between umbilical cord parameters and perinatal mortality. Materials and methods:This was a prospective study carried out in the Umaid Hospital, Dr. S N Medical College, Jodhpur from March-2014 to November-2014. It included 500 cases admitted to labour room with period of gestation >37 weeks. Details of delivery of baby including mode of delivery, Apgar score, NICU admission and any congenital anomaly found in unbooked cases post-natally was noted down. Umbilical cord parameters were also noted and correlated with perinatal outcome using Fischer's exact test and Chi square test. Results:Out of 500 cases, the cord length was normal in 88.2% cases while it was short in 6.2% and long in 5.6% cases. True knots were associated with a higher mean cord length of 95.83 ± 24.99 cm. The difference of mean cord length between single loop and more than two loops was highly significant (p value<0.001). Cesarean section rate was found to be significantly different between one loop and more than two loops (p<0.001). Conclusion:The excessively long cords are associated with cord prolapse, true knot and poor fetal outcome and increased operative interference. Short cords are associated with failed progress, cord rupture and congenital malformations. Nuchal cords are responsible for threatening fetal well being along with other placental as well as intrapartum factors for poor fetal outcome parameters of umbilical cord were examined at the time of delivery and after delivery: presence of any loop around neck, trunk, shoulder, etc. cord loops tight or loose in LSCS cases, number of loops of cord and positions, knots of cord (true or false), length and diameter of umbilical cord. Amongst these, we have excluded hypo and hypercoiled cords as there is much fluctuation in the number of coils with passage of time, postnatally. Determination of length of umbilical cord was done after the delivery of fetus, cord was clamped at two places and cut in between. From the cut end up to fetal umbilicus and placental attachment umbilical cord, length was measured with flexible tape in cm and added. A data check sheet was maintained for each case till completion of delivery. The umbilical cord length measurements were categorized into short, when the measured length was <39 cm, normal, when the measurement was between 39 to 95 cm and long cord if the measurement was >95 cm [1,2]. Statistical analysis was performed using SPSS17.0 for windows. The sample size of the study was calculated as 400 taking the power as 90% and 20% dropout. Continuous data were analyzed by t-test and categorical data by using Chi-square test or Fisher exact test. J Preg Child Health, an open access journal
Introduction:Umbilical cord plays an important role in the life of the fetus. Though variations in shape and other features of umbilical cord are common, some variations can adversely affect the pregnancy outcomes. Aims and objectives:The aim of our study was to study the correlation between the length of the umbilical cord in term gestation evaluated after birth and fetal outcome. Materials and methods:This study was carried out on 500 patients admitted in our hospital. It was a prospective study. In this study, the length of umbilical cord was measured after delivery in subjects who fulfilled the inclusion criteria. Examination of umbilical cord was done regarding the presence of any loop around neck, trunk, number of loops of cord and positions, presence of true or false knots of cord, or any other cord abnormalities, such as cord varix and cord hematoma. Fetal parameters regarding sex, weight, and length of the newborn and Appearance, Pulse, Grimace, Activity, and Respiration (Apgar) score at 1 and 5 minutes were measured and its correlation with umbilical cord parameters was studied. Results:In our study, the cord length varied from 16 to 144 cm. The mean cord length was 64.2 cm (±17.26 cm) and mean cord thickness was 1.21 cm (±0.39 cm). Maximum cases seen were in the group of cord length between 50 and 59 cm (27.8%). Lower sixth percentile was considered as short cord and upper sixth percentile was considered as long cord. A positive correlation existed between the cord length and birth weight and placental weight and body length of the newborn. There was no significant difference between sex of the fetuses and the cord length. Abnormal cord length cases (long and short group) have higher incidences of cord complications, and hence there was increased incidence of operative interference in such cases. The cases of long cord group had maximum number of lower segment cesarean section (46.43%). The significance was tested by using a chi-square test, and it was found to be statistically significant (p < 0.05). The incidence of birth asphyxia (21%) was significantly more in long and short cords as compared with normal length cords (p < 0.01).
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