Five Times of Cord Around Neck in Cesaren Section: A Case Report

Objective: We discussed a rare case of spinal muscular atrophy (SMA) type 0, was followed with prenatal diagnosis of intrauterine growth restriction (IUGR), five times of cord around neck detected during cesarean section, in the highlights of the literature. Case: A pregnant woman who was followed with the diagnosis of IUGR during 32. gestational week. In the 38. gestational week; cord around neck for five times and a real knot were detected in the cesarean section. Difficulty in swallowing and absorbing, also significant respiratory muscle weakness were found at the follow up of the baby. SMA was suspected according to these symphtoms. With the analyse of PCR RFLP (Polymerase chain reaction – restriction fragment length polymrphism) SMN 1 (Telomeric survival motor neuron gene) homozygot exon 7 and 8 deletions were found, SMA type 0 was diagnosed according to these findings. Conclusion: During the 2. trimester of pregnacy, with a careful ultrasound examination, cord around neck can be succesfully determined. It should be considered that cord around neck risk rate can be increased in the 3. trimester. Hypotonia, severe respiratory muscle weakness involving the infants to be a good antenatal and postnatal history, examination and molecular study will identify the rare cases of SMA. Genetic counseling should be given to the parents.