Effects of nuchal cord on fetomaternal outcome: an obstetrician challenge

Abstract

Objective:The objectives of the this study were to compare need of medical and surgical interventions and progress of labor, and feto-maternal outcome in patients with cord round neck versus without cord round neck at onset of labor or at term gestation. Methodology: This study was performed at NIMS Medical College Jaipur from January 2015 to January 2017. Total 200 cases were enrolled for a study, over a 2 year period. Among 200 patients, 100 control without cord round neck and 100 had cord round neck. Results: Among control groups 91% women delivered vaginally. Cesarean section was done in only 24% cases and 75% cases had delivered vaginally. Instrumental delivery in1%. Neonatal variables & obstetrical outcome were compared in tight nuchal cord groups and loose cord. In our Control group Majority of patients 75% were delivered vaginally. Loose nuchal cord does not associated with any adverse maternal & perinatal outcome. Tight cord round the neck associated with increased NICU admission with increased risk of low Apgar score. Evidence of fetal distress seen in 16% cases and outcome was poor in 3% cases. Conclusion: This is reasonably concluded from this study that cord round fetal neck remains a subject of anxiety for the paediatrician and for obstetrician & for the patient herself. Although with efficient mechanical supervision and by clinical observation "adverse circumstances which effecting the fetus will be averted in time although they do occur.

Determinan of Caesarean Section in Primigravidae: Case Control Study 2017-2019

“…Plasenta Previa plasenta yang menutupi seluruh atau sebagian dari ostium internal serviks (Meena et al, 2018).…”

“…Lilitan Tali Pusat tali pusat terlilit 360 derajat ke leher janin (Meena et al, 2018). Ya Tidak Gameli Kehamilan dengan jumlah janin lebih dari satu (Parlindungan et al, 2016).…”

“…Hasil penelitian ini sesuai dengan penelitian sebelumnya bahwa insiden lilitan tali pusat lebih banyak terjadi pada primigravida dan secara statitik bermakna (Nandhini et al, 2021). Lilitan tali pusat dapat menyebabkan beberapa kegawatan, antara lain janin tidak dapat bernapas di dalam rahim, mengakibatkan persalinan kala satu dan dua yang berkepanjangan, kelainan detak jantung janin, air ketuban bercampur mekonium selama persalinan, skor Apgar yang lebih rendah, asidosis pada janin, perawatan intensif neonatal, dan kematian janin (Joshi et al, 2017;Meena et al, 2018;Nandhini et al, 2021). Lilitan tali pusat yang persisten dapat menyebabkan pertumbuhan janin yang buruk dan memerlukan pemantauan ketat serta metode persalinan yang sesuai (Nandhini et al, 2021).…”