Open AccessObstetrical factors related to nuchal cord
Author(s) -
Ogueh Onome,
AlTarkait Aisha,
Vallerand Danielle,
Rouah Fabrice,
Morin Lucie,
Benjamin Alice,
Usher Robert H.
Publication year - 2006
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340500345428
Subject(s) - medicine , umbilical cord , cord , shoulder dystocia , obstetrics , cephalic presentation , pregnancy , fetus , surgery , anatomy , biology , genetics
Background. To investigate the intrapartum factors related to umbilical cord nuchal loops (nuchal cord) with particular reference to shoulder dystocia. Methods. We studied all singleton pregnancies with a vertex presentation and a birth weight of at least 2500 g from 1 January 1978 to 31 March 1997 and the 13,717 pregnancies with nuchal cord were compared to the 44,136 without nuchal cord. Results. When compared to pregnant women without nuchal cord, a greater proportion of pregnant women with nuchal cord underwent induction of labor (adjusted OR 1.09, 95% CI 1.04–1.15) and augmentation with oxytocin (adjusted OR 1.06, 95% CI 1.01–1.11). They had a longer second stage of labor ( p =0.0013) and a greater proportion of primiparous women with tight nuchal cord had second stage of labor that lasted longer than two hours (adjusted OR 1.21, 95% CI 1.03–1.41). The proportion of abnormal fetal heart rate patterns was higher in the presence of nuchal cord (adjusted OR 1.61, 95% CI 1.55–1.68). Shoulder dystocia occurred more commonly in association with nuchal cord, especially when the nuchal cord was tight (adjusted OR 1.50, 95% CI 1.30–1.72 for all nuchal cord; adjusted OR 1.82, 95% CI 1.42–2.34 for tight nuchal cord). Conclusions. Umbilical cord nuchal loops are associated with induction of labor, slow progress of labor, and shoulder dystocia.