Nuchal cord at delivery and perinatal outcomes: Single-center retrospective study, with emphasis on fetal acid-base balance

Vasa, Rohitkumar; Dimitrov, Roger; Patel, Shivani

doi:10.1016/j.pedneo.2018.03.002

Cited by 20 publications

(33 citation statements)

References 17 publications

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“…No significant relationship between nuchal cord and birth weight <2500g (OR 0.66; 95% CI 0.50, 1.35), or fetal growth restriction or small for gestational age infants (OR 1.41; 95% CI 0.90, 2.21) was identified. Studies of fetal growth restriction and small for gestational age were combined as they used a wide range of definitions [8,[38][39][40][41][42][43][44][45].…”

Section: Plos Onementioning

confidence: 99%

Umbilical cord characteristics and their association with adverse pregnancy outcomes: A systematic review and meta-analysis

et al. 2020

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Objective Current data on the role of the umbilical cord in pregnancy complications are conflicting; estimates of the proportion of stillbirths due to cord problems range from 3.4 to 26.7%. A systematic review and meta-analysis were undertaken to determine which umbilical cord abnormalities are associated with stillbirth and related adverse pregnancy outcomes. Methods MEDLINE, EMBASE, CINAHL and Google Scholar were searched from 1960 to present day. Reference lists of included studies and grey literature were also searched. Cohort, cross-sectional, or case-control studies of singleton pregnancies after 20 weeks' gestation that reported the frequency of umbilical cord characteristics or cord abnormalities and their relationship to stillbirth or other adverse outcomes were included. Quality of included studies was assessed using NIH quality assessment tools. Analyses were performed in STATA. Results This review included 145 studies. Nuchal cords were present in 22% of births (95% CI 19, 25); multiple loops of cord were present in 4% (95% CI 3, 5) and true knots of the cord in 1% (95% CI 0, 1) of births. There was no evidence for an association between stillbirth and any nuchal cord (OR 1.11, 95% CI 0.62, 1.98). Comparing multiple loops of nuchal cord to single loops or no loop gave an OR of 2.36 (95% CI 0.99, 5.62). We were not able to look at the effect of tight or loose nuchal loops. The likelihood of stillbirth was significantly higher with a true cord knot (OR 4.65, 95% CI 2.09, 10.37).

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Section: Plos Onementioning

confidence: 99%

Umbilical cord characteristics and their association with adverse pregnancy outcomes: A systematic review and meta-analysis

et al. 2020

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“…36% of overall cases being a primi. However, a strong association with advanced maternal age cannot be commented because of various socio-cultural factors, even though in a study by Vasa R et al [11] strong pre-disposition was seen in age 20-34 years, however author denied any relevance with maternal age due to longitudinal socio-cultural factors. Since in our study all patients were racially homogenous, we cannot comment on its association with CAN, but in multiple studies no racial relevance was identified.…”

Section: Discussionmentioning

confidence: 94%

“…Since in our study all patients were racially homogenous, we cannot comment on its association with CAN, but in multiple studies no racial relevance was identified. [11] As far as maternal morbidity is concerned no major life-threatening events were noted as an effect of nuchal cords ante-natally except co-existing medical conditions which seemingly has no role in CAN causation, neither its evidenced by other authors. About 7% patients had some obstetrical issue, mainly breech presentation, PROM and cord-prolapse, for which no relevant evidence can be found in contemporary studies and should be further investigated.…”

Section: Discussionmentioning

confidence: 96%

To Evaluate the Association of Cord around Neck at the Time of Delivery with Maternal and Peri-natal Outcomes

Kumar¹,

Jamal²,

Verma³

2019

AMDHS

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Nuchal cords have been invariably seen in pregnancies, sometimes discovered antenatally while more often as an incidental finding during birth. It sometimes can present as a complication to active labour, leading to unpredictable maternal and peri-natal morbidity and mortality. However, as often as nuchal cords are witnessed in clinical scenarios, only little is known in peer reviewed literature about their significance. There is an existing practical deficiency of guidelines and algorithmic measures to ensure maternal and neonatal wellbeing in a case of cord around neck. Diagnosis of nuchal cord is still a challenge during antenatal evaluation and not often taken in concern by obstetricians. In our study we study the incidence of nuchal cords with its overall aftermath with respect to maternal and neonatal parameters and attempt to probe the likely importance for its screening and developing guidelines.

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“…Thus effect of nuchal cord on fetus is suggested to be only transient without long term effect. Meconium stained liquor was seen in 9% of deliveries but only 2.3% of newborns suffered from meconium aspiration syndrome ( 8,12,19,20 The neonatal complications which were observed were not serious but were treatable and mostly occurred with tight nuchal cord but were not statistically significant.…”

Section: Neonatal Outcomementioning

confidence: 98%

Nuchal cord: from dread towards confident management

Shilpa

Moin

Fatima

2020

Int J Reprod Contracept Obstet Gynecol

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Background: This study was aimed at observing the outcomes of pregnancies with sonographically detected nuchal cord or cord around the neck at term. Early studies on nuchal cord showed many maternal and neonatal complications. But several recent studies have suggested that maternal and neonatal complications do not increase with nuchal cord at delivery. This ambiguity increases anxiety in treating obstetricians and relatives of pregnant women, thus leading to unnecessary caesarean sections. This study is intended to observe the maternal and neonatal outcomes of 300 pregnant women with sonographically detected nuchal cord at term. Methods: Prospective observational study where 300 term pregnant women with sonographically detected nuchal cord were observed through delivery at Shri Venkata Sai Medical College, Mahabubnagar, Telangana, during October 2016 to April 2018. Results: In this study 80.6% women had normal vaginal delivery, 8.3% had LSCS, 11% had instrumental deliveries. 54% had loose nuchal cord, 46% had tight loop of cord.60% had normal CTG, 8% had variable deceleration, 2% late deceleration. Neonatal morbidity was 9.6% and zero neonatal mortality. Conclusions:The study concluded that the presence of nuchal cord does not adversely affect the mother and the neonate. Presence of nuchal cord per se is not an indication for LSCS. Effect of nuchal cord on neonate is only transient. These women can be allowed for vaginal delivery with routine labour room protocols. Routine sonographycal detection of nuchal cord is not required and if it is reported, it should not dictate obstetric management.

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Nuchal cord at delivery and perinatal outcomes: Single-center retrospective study, with emphasis on fetal acid-base balance

Abstract: Perinatal outcomes of pregnancies with nuchal cord in predominantly African American and Hispanic women were not adversely affected. Analysis of umbilical cord blood gases suggests mixed respiratory and metabolic fetal acidosis.

Cited by 20 publications

References 17 publications

Umbilical cord characteristics and their association with adverse pregnancy outcomes: A systematic review and meta-analysis

Umbilical cord characteristics and their association with adverse pregnancy outcomes: A systematic review and meta-analysis

To Evaluate the Association of Cord around Neck at the Time of Delivery with Maternal and Peri-natal Outcomes

Nuchal cord: from dread towards confident management

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