Is Nuchal Cord a Perfect Scapegoat: A Retrospective Analysis from Northwest India?

Abstract

Background: Entanglement of the umbilical cord around the fetal neck (nuchal cord) is quite a common fi nding at delivery. It is often assumed that nuchal cord causes cord compression and thus low birth weight and intrapartum complications.  Aim: The aim of this article is to study the eff ect of nuchal cord on the mode of delivery, complications and fetal outcome.  Materials and Methods: A retrospective study was carried out on 386 deliveries, 60 of them with nuchal cord, during 1 year from November 2009 through October 2010. Their mode of delivery, complications and fetal outcome were studied and a comparison was established between nuchal cord group and the rest of the deliveries. Nuchal cord group was subdivided into loose nuchal cord (cord could easily be uncoiled before complete delivery of the baby) group and tight nuchal cord (cord was needed to be clamped and cut before delivery of the baby) group. Furthermore, the mode of delivery and fetal outcome were compared between these subgroups. Statistical analyses were performed using SPSS statistical soft ware version 12.0 (Chicago Illinios, USA). The results were expressed as percentages. Test for significance was done using Chi-square, and a P<0.05 was considered as significant. Results: The nuchal cord group did not have any signifi cant diff erence in the mode of delivery or fetal outcome compared with the control group. However, the subgroup having tight cord around the neck had significantly higher proportion of low Apgar scores and meconium staining at birth. Conclusions: Nuchal cord does not increase the chances of cesarean delivery. However, tight cord around the neck may result in low Apgar scores and increased incidence of fetal distress leading to cesarean section.  Keywords: Apgar score, cesarean delivery, meconium staining, north west India, nuchal cord, perinatal outcome