Perinatal outcome associated to fetal nuchal cord and way for delivery. Review of literature
DOI:
https://doi.org/10.18597/rcog.156Keywords:
umbilical cord, umbilical cord loop, ultrasound, fetal neck, nuchal cord, fetal mortalityAbstract
Introduction: a supposed increase in the risk of poor perinatal results regarding fetuses having an umbilical cord that is wrapped around their necks (nuchal cord) often leads to a cesarean operation having to be performed; however, it is not clear whether a nuchal cord is really associated with the frequency of poor fetal or neonatal results. This article has been aimed at reviewing publications about perinatal results associated with a nuchal cord and the safest birth route.
Materials and methods: a bibliographic search was made of PubMed, Ovid, SciELO and LILACS’ databases, as well as indexed journals and recognized medical societies: The American College of Obstetricians and Gynecologists, The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, The American Journal of Obstetrics and Gynecology and the Medical Journal Armed Forces India.
Results: 40 of the 520 titles reviewed complied with our selection criteria; they dealt with crosssectional, cohort, case and control and systematictype reviews. The studies showed that there were no significant differences between patients having or without a single-loop nuchal cord regarding intrauterine growth retardation (IUGR), reduced Apgar score at birth or perinatal mortality as parameters showing adverse perinatal results. The rates of cesareans in patients having single-loop nuchal cord were around 9% compared to 13% in patients where this had not occurred.
Conclusion: currently available evidence did not consistently support an association between the presence of nuchal cord and greater adverse perinatal results when compared to fetuses without nuchal cord. There is some risk in special situations such as multiple cord loops and wrapping of the cord around the neck. No evidence was found supporting carrying out a cesarean section regarding the presence of a single loop nuchal cord.
Author Biographies
Carlos Bustamante-Zuluaga
Guido Parra-Anaya
Felipe Vergara-Quintero
Israel Díaz-Yunez
Eduardo De Nubbila-Lizcano
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