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.. Objectives: To compare the effect of nuchal cord versus without cord around the neck on mode of delivery and fetal outcome. Study design: Case control comparative study. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir Syed Hospital Karachi. Material and Methods: A comparative study was carried out on 2 groups of parturient ladies. The study group comprised of those ladies who at the time of delivery (vaginal delivery/caesarean-section) had clinically cord around the neck while the other group (control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinatal outcome was measured in terms of Apgar score and NICU admission. High risk pregnancies were excluded from the study. Result: Incidence of nuchal cord at the time of delivery was 22.7%. A high rate of caesarean delivery observed in study group as compared to control group (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stained liquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively. Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admission was also not significantly different between the two groups. Conclusion: A significant high rate of caesareans section rate was observed in the study group mainly due to fetal distress (FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoring specially through intermittent CTG monitoring during labour so that fetal distress can be picked up early & emergency caesarean section can be performed to avoid fetal compromise.

FETAL OUTCOME; EFFECTS OF NUCHAL CORD VS WITHOUT CORD AROUND THE NECK ON MODE OF DELIVERY