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Önderoğlu LS, Dursun P, Durukan T. Perinatal features and
umbilical cord blood gases in newborns complicated with nuchal cord. Turk
J Pediatr 2008; 50: 466-470.
Presence of nuchal cord (NC) is associated with transient decrease of umbilical
cord blood flow. However, the exact perinatal effect of presence of NC in
a newborn is still under debate. The aim of this study was to evaluate the
perinatal complications and umbilical cord blood gases of deliveries complicated
with NC and summarize the associated literature. Gestational age-matched
term singleton pregnancies complicated with NC (n=160) were compared
with neonates without NC (n=160). Patients' files and Labor and Delivery
Unit database were used to extract maternal age, gestational age, presence of
NC, number of nuchal loops around fetal neck, intrapartum complications and
umbilical cord blood gases. pH, pO2, pCO2, HCO–3, O2 saturation, and base
excess were determined in all patients. Mean maternal age, mean gestational
age, and birth weight were not significantly different between the two groups
(p>0.05). Occurrence of oligohydramnios, intrauterine growth retardation
(IUGR), intrapartum abnormalities and Apgar scores <7 at 1 minute were not
significantly different between the groups (p>0.05). However, umbilical cord
blood pH (7.32 vs. 7.30, p=0.048), pO2 (37.4±18.1 vs. 31.7±14.4, p=0.01)
and O2 saturation (57.4±21.8 vs. 48.3±20.4, p=0.005) were significantly
lower in the NC group compared with the controls. Furthermore, the number
of Apgar scores <7 at 1 minute was significantly higher in neonates with
multiple NC (28.1% vs. 9.2%, p=0.007), and intrapartum abnormalities
were more frequently seen in newborns with multiple NC (31.3% vs.15.6%,
p=0.04). The results of this study suggest that presence of single NC may
negatively affect the umbilical cord blood gases without significant perinatal
complications. However, multiple NC may also increase the development of
intrapartum complications and lower Apgar scores. Perinatal effects of NC
should be investigated with a large prospective study.
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