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.