A Hospital-Based Study Evaluating the Impact of Umbilical Cord Abnormalities on Neonatal Outcome: A Retrospective Study

Description

Abstract (English)

Abstract
Aim: The aim of the present study was to assess the impact of umbilical cord abnormalities on neonatal outcome.
Material & Methods: A retrospective study was conducted in Department of Obstetrics and Gynaecology. 200
pregnant women with singleton pregnancy who delivered after 28 weeks of gestation during 1 year period, who
were diagnosed and documented as having umbilical cord abnormalities either antenatally or during and after
delivery were included in the study after taking informed and written consent.
Results: The age of majority of patients was in the range of 21-28 years as this group is most fertile. Primigravida
comprised of 40% whereas 60% were multigravida. 65% patients had normal vaginal delivery whereas 35%
patients required Caesarean section. Of all the abnormalities of umbilical cord, the most common abnormality
encountered is Nuchal cord (cord around the neck) with 70% cases in our study. Abnormal cord length i.e. Long
(>100cm) and short (<40cm) was seen in 12% cases. Rare abnormalities like vasa previa, velamentous insertion
and cord prolapse was seen in 1% cases each. Single umbilical artery was seen in 3% cases. Cord knot which
includes true as well as false knots was seen in 5% cases. Coiling abnormality which includes hyper as well as
hypo coiled cord was seen in 7% cases. Majority of the patients had APGAR score >7 at 1 and 5 minutes. 71%
fetus had live birth without any complication and did not require NICU admission. 20% required NICU admission.
4% had early neonatal death, 2% late neonatal death whereas 3% was still birth.
Conclusion: Umbilical cord abnormalities are a stress factor for fetus, where stillbirth can occur due to
combination of risk factors. This is especially important because most of these still births occur relatively late in
pregnancy in a setting of otherwise normal foetuses and pregnancies. Therefore, early detection and continued
surveillance will help to prevent such sudden fetal loss.