Perinatal Mortality and Umbilical Cord Parameters: Is there Any Association?

Abstract

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.