A Rare Case Scenario of Sextuple Nuchal Cord Entanglement

Mekala, Neethi Mala; Allanki, Suneetha

doi:10.5005/jp-journals-10006-1906

Cited by 1 publication

(1 citation statement)

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“…[3] Nuchal cords with four or more loops around the foetal neck are rare, although six, eight and nine loops have been reported previously. [4,5] Although the determinant of the number of nuchal loops remains unclear, it is proposed that this may be directly related to the length of the umbilical cord. While live births were recorded in all the referenced cases, the multiple loops, nevertheless, nuchal cord, especially if taut, may contribute to adverse obstetric outcomes, including meconium-staining of liquor, foetal heart rate abnormalities in labour, prolonged second stage of labour, increased need for surgical intervention in labour, perinatal asphyxia and perinatal mortality.…”

Section: Introductionmentioning

confidence: 99%

Cord Length, Umbilical Artery Lactate Concentration and Perinatal Outcomes of Babies with Nuchal Cord at Ile-Ife, Nigeria

Awowole¹,

Badejoko²,

Adeniyi³

et al. 2023

Ann Health Res

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Background: There is inconclusive evidence on the relevance of the nuchal cord in obstetric practice. Objectives: This study aims to evaluate the umbilical artery lactate concentration and perinatal outcomes of babies born with a nuchal cord. Methods: In a cross-sectional study at the Obafemi Awolowo University Teaching Hospital, babies born with a nuchal cord at term and matched controls without a nuchal cord were recruited between January 2017 and December 2018. Gestational age at delivery, meconium-stained liquor, foetal heart rate abnormalities, Caesarean section rates, cord lengths and umbilical artery lactate concentrations were compared. The umbilical artery lactate concentration was assayed with the Lactate-Plus®; neonatal acidosis was defined as cord lactate concentration > 4.9mmol/L. Results: One hundred and forty-four babies with nuchal cords and 144 controls were recruited. The prevalence of nuchal cord was 3.4%, with 80% of the babies having a single loop. Babies with nuchal cords had longer mean cord length (57.7cm vs 45.4cm; p<0.01), higher mean umbilical artery lactate (4.93mmol/L vs 3.48mmol/L; p = 0.04), meconium-stained liquor (16% vs 3.2%; Relative risk = 4.6), more babies with Apgar score <7 at fifth minute (9 versus 4 babies) and increased perinatal mortality (55.5/1000 births vs 13.8/1,000 births; Relative risk = 4). There was a positive correlation between cord length and the number of nuchal loops (r = 0.5, p<0.01). Conclusions: Nuchal cord is associated with abnormal cord lactate concentration and adverse perinatal outcomes. Prenatal reporting may enhance intrapartum surveillance and improve perinatal outcomes.

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Section: Introductionmentioning

confidence: 99%