Outcomes of Pregnancies With Sonographically Detected Nuchal Cords Remote From Delivery.

Obstet Gynecol Surv. 2004 Jul;59(7):499-500.

Outcomes of Pregnancies With Sonographically Detected Nuchal Cords Remote From Delivery.

Gonzalez-Quintero VH, Tolaymat L, Muller AC, Izquierdo L, O'Sullivan MJ, Martin D.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, 
University of Miami School of Medicine, Miami, Florida.

Numerous reports have associated a nuchal cord with an elevated risk of adverse 
pregnancy outcomes. Most of these focused on cases in which a nuchal cord was 
detected before delivery. This retrospective study included 118 consecutive 
women found by sonography to have a nuchal cord in the second or third trimester 
of pregnancy (17-36 weeks gestation). The 115 control women were matched with 
the study group for gestational age at the time of sonography. Both sagittal and 
transverse images were acquired. The findings on 2-dimensional ultrasonography 
were confirmed by a color Doppler flow study. The study and control groups were 
similar with respect to maternal age, race, ethnicity, gestational age at the 
time of sonography, and birth weight. Just over half of nuchal cord cases (51%) 
were diagnosed in the second trimester. The condition was significantly associated 
with delivery before 37 weeks gestation. The risk was 21% in study women and 11% 
in the control group. The prevalence of a nuchal cord at delivery was 37% in 
women diagnosed sonographically and 15% in the control group. There were no 
significant group differences in method of delivery, indications for cesarean 
delivery, or meconium-stained amniotic fluid. Fetal heart rate abnormalities, 
5-minute Apgar scores, and admission to neonatal intensive care also were 
comparable in the 2 groups. There was 1 intrauterine fetal death in each group. 
Finding a nuchal cord by sonography in the second or third trimester of pregnancy 
is associated with preterm delivery but not with serious perinatal complications.

PMID: 15199256 [PubMed - as supplied by publisher] 


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