FREQUENCY OF NUCHAL CORD AT DELIVERY BETWEEN 36 TO 41 WEEKS AND TO ASSESS THE PERINATAL OUTCOME

Objective: To determine the frequency of nuchal cord at delivery between 36 to 41 weeks and to assess the perinatal
outcome.
Methodology: This retrospective, comparative study was carried out from January 2012 to June 2012 at Peshawar
Health Center, Peshawar. Out of the total 116 deliveries, 56 cases were selected as study group according to the
inclusion criteria and the remaining cases (n = 60) which did not have nuchal cord served as control group.
Variables like meconium staining of liquor, transient fetal heart rate (FHR) irregularities, fetal distress, instrumental
delivery rate, caesarean section rate, apgar score <7 at 1 minute and 5 minute and admission to neonatal unit were
taken as outcome variables. Outcome variables between the study group and control group were compared.
Results: Out of the 116 women delivered after 36 weeks of gestation, 56 cases had nuchal cord making its incidence
of 48.28% of all the deliveries. The incidence of single loop of cord around neck was 87.5% while multiple loops of
cord around neck were 12.5%. Rate of caesarean section in study group (28.6%) was nearly equal to control group
(25%), however the rate of instrumental deliveries was higher in study group 35.7% (n=20) than control group 23.3%
(n=14). Transient FHR irregularities were more common in study group. Similarly meconium staining of the liquor
was also more in study group (32%) than in control group (15%). Apgar score <7 at 01 minute was found in 16%
(n=9) of newborn in study group and nil in control group. Five minute apgar score < 7 in both study and control group
was nil. Neonatal unit admission was needed by 8.9% (n=5) in study group and nil in control group.
Conclusion: Nuchal cords occur commonly, but are rarely associated with significant neonatal morbidity or mortality.
Key Words: Nuchal cord, Perinatal outcome, Apgar score,