A nuchal cord occurs when the umbilical cord becomes coiled around the neck of the fetus, most often in a single-coil, but in some cases, multiple coils.
Nuchal cords occur in 10-30% of all births.
Sometimes a nuchal cord happens for no apparent reason. However, a
few of the common risk factors include:
- Long cord, Excessive Amniotic Fluid, Twins.
- Large -sized Fetus. Breech Presentation or Transverse Lie.
It is a finding on Colour Doppler Ultrasound with its pros and cons. Before labour starts, there may not be an association between a nuchal cord and reduced fetal movements. Of cord around neck persists till labour pains start, the Fetus may be at risk for :
- Restricted Blood Flow. Decreased Oxygen.
- The decrease in Fetal Heart Rate.
The Presence or Absence of Nuchal Cord did not have a statistically significant difference in markers of Neonatal Outcome, like 1. Apgar score at 1 minute 2. Arterial cord pH, 3. Abnormality in CTG(Cardiotocography) at any time or at Delivery or 4. Mode of Delivery i.e. Vaginal or Instrumental Delivery or Caesarean Section.
The presence of two or more loops of Nuchal Cord (cord around the neck) increases the risk of complications to the Fetus and the Neonate, which may justify Cesarean Section Operation.
We have understood the above information and we have studied the subject ourselves also and we have reviewed various options, including
1. Wait and watch for Fetal Well Being.
2. Wndergo Elective (Planned) Caesarean Section Operation.