Publication:

A case-control study on perinatal outcome in neonates with cord around the neck in a tertiary care hospital, Hubli, Karnataka

Background Intra-partum finding of umbilical cord around the baby’s neck is a common finding, seen in about a third of normal deliveries. This nuchal cord has often been the scapegoat for complicated deliveries with adverse outcome like asphyxia or stillbirth. The aim of the study is to compare the perinatal outcome in full term vaginal deliveries in babies with cord around the neck and without cord intra-partum.

Methods A total of 300 full term deliveries in labour were studied, with 150 cases with a single or multiple loops of cord and another 150 cases without cord around the neck. The cases were chosen randomly in a study period between August 2012 and May 2013. Perinatal outcome is analysed in the new-borns by means of APGAR score of the neonate at 1 and 5 minutes, NICU admission and complications till day 7 of life.

Results 74% of the 150 deliveries with the cord around the neck were uneventful with clear liquor status and normal FHR variability. 22% of the cases had thin meconium stained liquor and 4% were associated with thick meconium stained liquor. The difference in the Apgar score at 1 and 5 minutes between the study and the control group was statistically not significant. Also there was no statistically significant difference in NICU admissions and neonatal morbidity.

Conclusions The study has concluded that the finding of cord round the neck in fetuses does not cause any specific adverse outcome in properly monitored labor. The study has not shown any stillbirth that could be attributed to the cord. Hence, mention of a nuchal cord in the ultrasound reports does not warrant panic and a safe vaginal delivery can be contemplated successfully.