“A Clinical Study Of Feto-Maternal Outcome In Relation To One Or More Than One Loops Of Cord Around Neck”
Main Article Content
Abstract
Nuchal cord, one or more loops is a common finding at delivery, but its clinical relevance is not entirely clear. Different results have been obtained from several studies that have analysed deliveries with nuchal cords1-5.
Midwives have been taught, for over 200 years, that when the head is born in a vertex presentation, they should feel for the cord around the neck6, and, if found, loop it over the head, slip it over the shoulder or severe the cord. If the cord is loose, baby can be delivered normally7,8. If the cord is too tight to go over infant’s head, it can be slipped over the infant’s shoulder and deliver the body through the cord, the cord can then be unwrapped from around the baby after birth. If the cord is too tight to slip back over the shoulder, one may use the somersault manoeuvre to deliver the baby9,10. The cord can also be clamped and cut to allow for vaginal delivery if other methods of nuchal cord management are not feasible.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Crawford J S. Cord around the neck. Acta Paediatrica. 1962; 51 (5): 594-603.
Schreiber H, Daykan Y, Arbib N, Markovitch O, Berkovitz A, Biron-Shental T. Adverse pregnancy outcomes and multiple nuchal cord loops. Arch Gynecol Obstet. 2019 Aug;300(2):279-283.
Murlewska J, Poszwa P, Sylwestrzak O, Respondek-Liberska M, Wood D. The Presence of a Single Nuchal Cord in the Third Trimester May Not Affect Tei Index in LGA Fetuses. Int J Environ Res Public Health. 2023 Feb 21;20(5):3778.
Młodawska M, Młodawski J, Świercz G, Zieliński R. The Relationship between Nuchal Cord and Adverse Obstetric and Neonatal Outcomes: Retrospective Cohort Study. Pediatr Rep. 2022 Jan 24;14(1):40-47.
Balsak D, Erol O, Toz E, Tahaoglu AE, Togrul C, Eser A, et al. Perinatal outcomes of sonographically detected nuchal cord in southeastern Turkey. Clin Exp Obstet Gynecol. 2017;44(3):395-397.
Clapp III JF, Stepanchak W, Hashimoto K, Ehrenberg H, Lopez B. The natural history of antenatal nuchal cords. American journal of obstetrics and gynecology. 2003 Aug 1;189(2):488-93.
Mercer JS, Skovgaard RL, Peareara-Eaves J, Bowman TA. Nuchal cord management and nurse-midwifery practice. Journal of midwifery & women's health. 2005 Sep 1;50(5):373-9.
Jackson H, Melvin C, Downe S. Midwives and the fetal nuchal cord: a survey of practices and perceptions. J Midwifery Women Health 2007;52(1):49-55.
Reed R, Barnes M, Allan J. Nuchal cords: sharing the evidence with parents. Br J Midwifery 2009;17(2):106-9.
Schorn MN, Blanco JD. MANAGEMENT OF NUCHAL CORD. Journal of Nurse‐Midwifery. 1991 Mar 4;36(2):131-2.
Chapman E. Improvement of Midwifery. London: 1753. p. 126
Weber T. The influence of cord complications on fetal pH, neonatal APGAR score, and the acid base state and oxygenation of the umbilical artery and vein. J Perinat Med 1981; 9: 134-40.
Nelson KB, Grether JK. Potentially asphyxiating conditions and spastic cerebral palsy in infants of normal birth weight. Am J Obstet Gynecol 1998;179:507-13
Clapp III, J Lopez B, Simonean S. Nuchal cord and neurodevelopmental performance at 1 year. J Soc Gynecol Investig 1999; 6: 268-72.
Wilson B. Sonography of the placenta and umbilical cord. Radiologic Technology. 2008 Mar 1;79(4):333S-45S.
Larson JD, Rayburn WF, Crosby S, Thurnau GR. Multiple nuchal cord entanglements and intrapartum complications. American journal of obstetrics and gynecology. 1995 Oct 1;173(4):1228-31.
Oenderoglu LS, Dursun P, Durukan T. Perinatal features and umbilical cord blood gases in newborns complicated with nuchal cord. The Turkish journal of pediatrics. 2008 Sep 1;50(5):466.
Adinma JI. Effect of Cord entanglement on Pregnancy outcome. Intl J Obs Gyn 1990 May; 32(1): 15-8.
Abdallah A, Eldorf A, Sallam S, Ahmed S, Shawky M, Nawara M, et al. Nuchal cord: impact of umbilical artery Doppler indices on intrapartum and neonatal outcomes: a prospective cohort study. J Matern Fetal Neonatal Med. 2019 Oct;32(20):3367-3378.
Mastrobattista JM, Hollier LM, Yeomons ER, Ramin SM. Day MC, Sosa A, Gilstrap LC 3rd. Effects of nuchal cord on birth weight and immediate neonatal outcomes. Am J Perinatol. 2005; 22(2): 83-5.
Sheiner E, Abramowicz JS, Levy A, Silberstein T, Mazor M, Hershkovitz R. Nuchal cord is not associated with adverse perinatal outcome. Archives of Gynecology and Obstetrics. 2006 May;274:81-3.
Tagliaferri S, Esposito FG, Esposito G, Saccone G, Signorini MG, Magenes G, et al. Impact of nuchal cord on antenatal and intrapartum foetal heart rate surveillance and perinatal outcome. J Obstet Gynaecol. 2020 Apr;40(3):316-323.