Introduction
The umbilical cord, a pulsating rope of 2 arteries and a vein
intertwined around each other, represents the very crux of forthcoming
life. It may undergo many difficult times like being stretched, coiled,
compressed, and knotted. It can wind itself around the fetal body or
neck (nuchal cord - NC). Amongst all, an NC is most frequently
encountered (8 -35.%). 1,2,3,4
The points of concern with it are
Which pregnant women are likely to have an NC?
Which pregnancy with NC will have an adverse perinatal outcome?
It may be hypothesized that excessive fetal movements and long umbilical
cords are prone to cord entanglements; it is not established why it
occurs in some cases, whereas in other cases, it does
not.5 Some studies indicated that male
sex6 and acute onset polyhydramnios7are associated with NC. In other studies, maternal and gestational age
at delivery, parity, fetal gender, and fetal birth weight are not
associated with NC.8,9
Several studies had been conducted to understand the perinatal effects
of the nuchal cord.10 The possibility of higher rates
of umbilical cord compression in the presence of NC (three or more
loops), causing fetal distress or even asphyxia and intrauterine death,
was put forth.11, 12 Most studies agree that tightness
of NC causes fetal distress.11, 13, 14 However, many
other studies showed no perinatal adversities.15, 16,
17 The diagnosis often triggers significant uncertainty and anxiety in
pregnant patients.10
Fetal circulation is one of the essential factors for an amniotic fluid
generation. Any disturbance in its course (due to NC) and the duration
of the disturbance should affect the amniotic fluid volume. However,
there are few experiments in this area. Recently, acute onset
polyhydramnios has been attributed to a triple nuchal cord, possibly
limiting fetal swallowing.7 The relation of amniotic
fluid and the nuchal cord needs to be evaluated. Likewise, it is
essential to know which patients are prone to develop an NC and which
patients with NC are likely to result in fetal distress.
We, through this study, tried to figure out the epidemiological factors
responsible for the nuchal cord. We used maternal age, education level,
socioeconomic status, parity, and fetal gender. We assessed the liquor
antenatally and intranatally to evaluate its role in NC. The fetal
outcome using fetal birth weight, 1st min APGAR score,
need for oxygen (O2) more than 30 mins, and the need for
NICU care was examined.