Incidence of nuchal cord and its effect on mode of delivery and fetal outcome.

Abstract

Objective: To determine the frequency of nuchal cord in term pregnancies and to evaluate maternal outcomes (cesarean section or vaginal delivery) and neonatal outcomes (low birth weight, poor APGAR score, or intra-partum loss) in patients with nuchal cord. Study Design: Descriptive Cross-sectional study. Setting: Department of Obstetrics and Gynecology, Maternal Newborn & Child Healthcare Unit, Faisalabad. Period: June 2024 to November 2024. Methods: Sample size of 369 term pregnancies (36–40 weeks). Patients were selected using non-probability consecutive sampling. Demographic details, nuchal cord presence, delivery mode, and neonatal outcomes (low birth weight and APGAR scores) were recorded. Data analysis was performed using SPSS version 26, with stratification for effect modifiers such as age, gestational age, parity, and number of cord loops. A p-value ≤0.05 was considered significant. Results: The frequency of nuchal cord was 24.4%. Maternal outcomes were not significantly affected by nuchal cord presence, as 72.2% of cases with nuchal cord had vaginal deliveries (p=0.199). Neonatal outcomes showed no significant relationship with nuchal cord presence: Low birth weight (<2.5 kg): 11.1% (nuchal cord) vs. 8.6% (no nuchal cord) (p=0.474). Poor APGAR scores (<7): 41.1% (nuchal cord) vs. 38.4% (no nuchal cord) (p=0.641). The number of cord loops did not significantly impact delivery mode or neonatal outcomes. Conclusion: Nuchal cord was common in term pregnancies but was not associated with adverse maternal or neonatal outcomes. Routine detection of nuchal cord should not prompt unnecessary cesarean sections. Future research should focus on multiple nuchal cords and their long-term neonatal implications.